Cameron, Lee-AP 2013-09-13SEP 13 2013
This information is a public record. For Pffice Use Only
Public Service opportunities are offered hr the City Of'Coppell without regard I CITY OF COPPELL
to race. color. national oriuin, ref lion, sex or disability. DatdRemw Resource Department
If you are interested in applying for more than one position (maximum of three), please indicate the order of your preference by
placing a number in the space to the left of the board/commission/committee for which you are applying (#I being your Ist
choice, #3 being your last choice). Note: Youth Advisors are for students in grades seven through eleven and are not eligible for other
Boards.
ANIMAL SERVICES ADV. & APPEALS
BOARD OF ADJUSTMENT
_—_ECONOMIC DEVELOPMENT COMMITTEE
KEEP COPPELL BEAUTIFUL
LIBRARY BOARD
PLANNING AND ZONING COMMISSION
_o CONDUCE REVIEW BOARD
SPECIAL COUNSEL
YOUTH ADVISOR -KEEP COPPELL BEAUT]FUL
YOUTH ADVISOR -LIBRARY BOARD
YOUTH ADVISOR -PARK & REC BOARD
If asked to serve on a different board than you indicated, would you be interested? (Circle one) Y N
Would you be interested in serving on any AD Iloc Committees or Citizen Summits that may arise during the year? (Circle one) Y N
Would you be interested in serving on any non-prolit organization/committee/ task force that may arise during the year? (Circle one) Y N
Ano'
Ms.
Mrs
Mr.
PLEASE TYPE OR PRINT THE FOLLOWING INI'ORMATION CLEARLY
C;Q-r� (e tro [n _ - iL�
Last Nam First Name MI
remiss ,, e .[� Code Home Phone
4_5 TR
ddress -%- / Zit) (Ac usiness Phone
Resident of City for /% years? Qualified voter in the City of Coppell? (Circle one N
If applying for Youth Advisor indicate grade for 2013-2014.
Email Address (required if available)
List any experience that qualifies you to serve in the positions sought
166 atree-ml.w-Je
Have you ever served as a rnen:ber of any Coppell boards/commissions/committees? (Circle one) Y 11--)
r�re5,
If yes, specify which one and the approximate dates of service.
1 -lave you attended one or more meetings of the board/commission for which you have applied? (Circle one) Y ON
List any civic or community activities in which you have been involved.
Do you have any business or personal relationship with the City of Coppell that would affect your ability to
have impartial judgment in City matters? (Circle one) Y
If yes, please explain
1 List your educational background. &—
do 17,,/ Cf.,,`
�'
What is your current place of emplo rnent or business affiliation? (Please indicate if you are self-employed or
not employed.)��jer� �'ips oar z_ E�e�n� d�c �•^ 4.4e?—
What is your occupational experience?
PLANNING & ZONING OR BOARD OF ADJUSTMENT APPLICANTS — Please answer the following:
Do you have working knowledge in any of the following areas:
❑ Real Estate/Development ❑ Business Development Law/Contract Administration
❑ Land Use Concepts and Master Plan ❑ Manufacturing/Industrial Operations
ECONOMIC DEVELOPMENT COMMITTEE APPLICANTS — Please answer the following:
Do you have working knowledge in any of the following areas:
❑ Real Estate/Development ❑ Banking/Finance ❑ Business Management ❑ Promotion/Marketing
❑ Law/Contract Administration ❑ Manufacturing/Industrial Operations
This application is the only information considered for appointments by the City Council.
Please do not send resumes, business cards, photographs or letters of recommendation.
Please call (972) 304-7016 for more information about the City's boards, commissions and committees.
NOTE: APPLICATION MUST BE SIGNED BELOW BY APPLICANT.
STATEMENT OF INTENT: "If appointed, I agree to serve on the Board/Commission for which I have applied.
1 do solemnly swear (or affirm), that I have not directly or indirectly paid, offered, promised to pay, contributed, or
promised to contribute any money or thing of value, or promised any public office or employment as a reward to secure
my appointment or confirmation, so help me God."
Date: Signat�
Return to: Boards & Commissions, % City Secretary - P. O. Box 9 8, Coppell, TX 75019
Or in person: City Secretary's Office - 255 Parkway Blvd., Coppell, TX 75019
(Deadline for returning application is Friday, September 13, 2013 at 5:00 p.m.)
INTERVIEW SCHEDULE
Park & Rec. Board Youth
Library Board Youth
Library Board
Economic Development
Board of Adjustment
- Mon., Oct. 7 KCB Youth
- Wed., Oct. 9 Animal Services Adv. & Appeals
- Tues., Oct. 15 Planning & Zoning
_Wed., Oct. 16 Keep Coppell Beautiful
- Thurs., Oct. 17
- Thurs., Oct. 17
- Thurs., Oct. 24
- Wed., Oct. 30
- Thurs., Oct. 31
71 --