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Nadler, Olivia-AP 2013-09-04This information is a public record.FafS�PiV4J2VWy Public Service opportunities are offered by the City Of Coppell without regard to race, color, national origin, religion, sex or disability. DatCi City of 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 I st 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 CONDUCT REVIEW BOARD BOARD OF ADJUSTMENT SPECIAL COUNSEL CONOMIC DEVELOPMENT COMMITTEE YOUTH ADVISOR -KEEP COPPELL BEAUTIFUL KEEP COPPELL BEAUTIFUL YOUTH ADVISOR -LIBRARY BOARD LIBRARY BOARD YOUTH ADVISOR -PARK & REC BOARD PLANNING AND ZONING COMMISSION If asked to serve on a different board than you indicated, would you be interested? (Circle oneN Would you be interested in serving on any AD Hoc Committees or Citizen Summits that may arse during the year? (Circle one) Would you be interested in serving on any non-profit organization/committee/ task force that may arise during the year? (Circle on 0Y N ❑ s. C)X Mrs. ❑ Mr. Last N Home Address Business Address PLEASE TYPE OR PRINT THE FOLLOWING INFORMATION CLEARLY Name go/ Zip Code Zip Code MI T- Home Phone (222 a52 Business Phone Resident of City for r ;z years? Qualified voter in the City of Coppell? (Circle ont If applying for Youth Advisor indicate grade for 2013-2014. Have you ever served as a of any Coppell boards/commissions/committees? (Circle one) Y 0 If yes, specify which one and the approximate dates of service. N Have you attended one or more meetings of the board/commission for which you have applied? (Circle one) Y CN) 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 t have impartial judgment in City matters? (Circle one) Y � If yes, please explain List your educational background. What is your current plac of employment or business affiliation? (Plea a mca e if youre self -e ployed or not employed.) �r p�f�P� �/� 6t lok-9 �/ �?Lli� P//%f'>C1 . /Ji/" /- P) r PLANNING & ZONING OR 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: Doyou have working knowledge in any of the following areas: / Real Estate/Development ElBanking/Finance Ltd Business Management E 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. I 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: / Signature: go Return to: Boards & Commissions, % City Secretary - P. . Box 9478, 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 Board of Adjustment - Thurs., Oct. 17 Park & Rec. Board Youth - Mon., Oct. 7 KCB Youth - Thurs., Oct. 17 Library Board Youth - Wed., Oct. 9 Animal Services Adv. & Appeals - Thurs., Oct. 24 Library Board - Tues., Oct. 15 Planning & Zoning - Wed., Oct. 30 Economic Development - Wed., Oct. 16 Weep Coppell Beautiful - Thurs., Oct. 31