TEST TESTm M I AM I B EAC H ~~T,,~ o~ M~~~M~ 6EA~H
BOARD AND COMNiITTEE APPLIGATION FORNi
NAME;
susiness Name:
Professional
F~pires Aliach d coA), n! !i.~ ;,c::itsc
Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, an0 commiltees shall be affiliated with ihe city; this
requirement shall be fulfilled in the following ways- a) an intlividual shall have been a resident of the city for a minimum of six
months; or b) an individual shall demonstrate ownership/interest for a minimum of six months in a business established in the city.
• Resident of Miami Beach for a minimum of six (6) months: Yes _I or No C
• Demonstrate an ownershiplinterest in a business in Miami Beach for a minimum of six (6) monihs: Yes f i or No _
. Are you a registered voter in Miami Beach: Yes ~ or No L
•(Please circle one): 1 am now a resident of, North Beach South Beach Middle Beach
• I am applying for an appoinVnent because I have special abilities, knowiedge, experience. Please list below:
Please list your preferencas in order of ranking [1] first choice [2] secon0 choice. ana ~3~ trnra cnoice. r~ease noce v~ac onn mrer i~~
choices will be observed bv the Citv Clerk's Office. (Regular Boards of CRy)
Affordable Housing Advisory Committee ^ Historic Preservation Board =~
f 0 Art in Public Ptaces Committee ^ Housing Authority
' I Beach Preservation Board ~ Loan Review Committee _
Beautification Commitfee
C ~ Manne Authonry ,
~
~ Board of Adjustment' I I Miami Beach Commission for Women
Budget Advisory Committee
__ L Miami Beach Cultural Arts Council _
_ .. _
_
C Capital Improvements Projects Oversight Committee C Miami Beach Sister Cities Program _ _
C Committee on the Homeless
- - ~ Normantly Shores Local Gov't Neigh. Improvement
-
,i Committee for Quality Education in MB ^ Parks and Recraation Facilities Boartl
CI Community Development Advisory _ ^ Personnel Board _
C Communi Relations Board i Planning Board" _
G Convention Center Advisory Board ~ Police Citizens Relations Committee _
~ CulWra! Arts Neighborhood Distnct Oveda CANDO
~ ^ Production Industry Council
Debarment Committee __ i C Public Safety Advisory Committee
C Design Review Board` 0 Safery Committee _ ~
~ Disabiliry Access Committee ~ Sin le Family Residential Review Panal
'1 Fine Arts Board ^ Sustalnability Commitlee .____
"
^ Gay Business Development Ad Hoc _ I
~ Transparency Reliability & Accountability Committee "TR,4C
G GOIf Advisory CommittBe ~ i ransponuuvn aiw ra~n~~~y ~,.,~~~~~. _ __I
I Health Advisory Committee I i Visitor and Convention Authoriry
0 Health Facilities Authority Board C Youth Center Advisory Board _
'~Hispanic Atfairs Commfttee . - - -i
I ~ " Board Raquirotl to File State Diaclosure fortn _
h:\CiiR'~SkIC~aFOiMS\RCiARDANQ ~~::'MMI-I_'_j~BC Anpl~c~Non [1 iQ9.doc