Rosalie Pincus Board application and resume 12/16/9~~ MIANIIBEACFi
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NAAAE~ ~~` ~1C ~ S ~ U S~ ~/ ~..
Last Name First Name
HOME ADDRESS: 1( ~~LS'~b y1rB~j~P IQb t ~S{„'~
No. treet
PHONE: ~~~~~ ,~ ~ ~ ~- Ue14"I
Fax
Business Name:
Address:
Position:
Middle Initial
City ~Sriaie ~Ip Code
--~oSi~f .~r~t~_QQC C~yt
Email address
No. Street City State Zip Code
Professional License (describe) Expires: A#tnch ~ co}~Y cif zt~e :icense
Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and committees shall be affiliated with the city; this
requirement shall be fulfilled ~in the following ways: a) an individual shall have been a resident of the .city for a minimum of six
months; or b) an individual shall demonstrate ownership~nterest for a minimu/m of six months in a business established in the city.
• Resident of Miami Beach for a minimum of six (6) months: Yes ~r No ^
• Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (ti) months: Yes ^ or No ~3~
• Are you a registered voter in Miami Beach: Yes ~Lc~r No ^
• (Please check one): 1 am now a resident of: North Beach ^ South Beach ~e Beach ^
• ! aim applying for an appointment because I have special abilities, knowledge, experience. Please list below:
Please fist your preferences in order of ranking [1] first choice [2) second choice, and [3J third choice. Please note that only three (3)
choices will be observed by the City Clerk's Office. (Regular Boards of City)
^ Art in Public Places Committee
^ Beach Preservation Board
^ Beautification Committee
^ Board of Adjustment*
^ Budget Advisory Committee
~P Committee on Homeless
^ Committee for Qtaality Education in MB
D Community Development Advisory'
^ Community Relations Board
^ Convention Center Advisory Board
^ Debarment Committee
D Design Review Board*
^ Disability Access Committee
^ Fine Arts Board
^ Golf Advisory Committee
^ Health Advisory Committee
Health Facilities Authority Board
0 Hispanic Affairs Committee
^ Historic Preservation Board*
* Board Required to File State Disclosure form
^ Housing Authority*
^ Loan Review Committee*
^ Mayor's Green Ad-Hoc Committee
^ Marine Authority*
^ Miami Beach Cultural Arts Council
^ Miami Beach Commission For Women
^ Miami Beach Florida Sister Cities
^ Normandy Shores Local Gov't Neigh. Improvement
^ Oversight Committee for General Obligation Bond
D Parks and Recreation Facilities Board
Personnel Board*
^ Planning Board*
^ Police Citizens Relations Committee
^ Production Industry Council
^ Public Safety Advisory Committee .
^ Safety Committee
^ Transportation and Parking Committee
^ Visitor and Convention Authority*
^ Youth Center Advisory Board
F:!CL.Eu1SALt~`:8&C; Ac7Piir.,ation Revirt~d C7t:tuher 25, ' i?~.cioc, 1
m
Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center:
5. Past service on the Youth Center Advisory Board: Yes ~ No ^ Years of Service:
2. Present participation in Youth Center activities by your children Yes~._i No ~7. If yes, please list the names of your children, their
ages, and which programs. List below:
Child's name: Age: Program:
Child's name:
Age: Program:
_•Have you ever been convicted of a felony: Yes ^ or No GNfyes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or Nom yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: Yes ^ or No~I. If yes, explain in detail '
' • Are you currently serving on any-City Boards or Committees: Yes~No ^. If yes; which board?
~dCL~---
d 1 ~~G ~~IZ~Pt~ _~ Y lt1'Jt/J
• What organizations in the City of Miami Beach ~d/o you currently hold ;membership in?
Name: n D o ~ ~ ~ 52A Title:
Name: Title:
=: • List all properties owned or have an interest in, which are located within the City of Miami Beach:
•.I,am now employed by the City of-Miami Beach: Yes ^ or No .Which department?
• Pursuant to City Code Section 2-25 (b): Do you have a parent ^, spouse ^, child ^, brother ^, or sister ^ who is employed by the
'" City of Miami Beach? Check all that apply. Identify the department(s):
This section is "not required" but desired: Age: years old Gender: Male ^ Female 0~
Ethnic O ' in (Check one)
White African-American/Black ^ Hispanic: D Asian or Pacific Islander ^ American Indian or Alaskan Native ^
Employment Status: Employed ^ Retired r~me-maker ^ Other ^
"I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2,
Article VII - of the City Code "Standards of Conduct for City Officers, Employees and Agency Members."
Appli nt's Signature Date Name of Applicant (PLEASE RINT)
Please attach a copy of your resume to this application
NOTE: Applications will remain on file for a period of one (1) calendar year.
Received in City Clerk's Office by Date
Name of Deputy Clerk
Document Control Number (Assigned by the City Clerk's Office) Entered By Date
Revised ~n5~o7 io
F:`•CLcR~$ALL`.8~; A~plic,~a~icn 4:~visnd 7ctcb~s 25, zC:G7.~ioc 2 -g _
ROSALIE B. PINCUS
11 Island Avenue Apt. # 1512 Miami Beach, Florida 305-532-4247
WORK EXPERIENCE
Miami Beach Senior High School, Miami Beach, Florida
• Counselor, College Assistant Program, 1982-2002
VOLUNTEER EXPERIENCE
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:Minority and Women Owned Business Advisory Board, Miami-Dade County
Appointed 2003
Personnel Board City of Miami Beach, Member and Past Chairperson
Appointed 1999
Mount Sinai Medical Center Board of Trustees, Miami Beach, Florida
Appointed 1977, Appointed Lsfe Trurtee 1993
Miami Jewish Home and Hospital for the Aged ,Miami, Florida
Board of DirectorrAppointed 1986
Douglas Gardens Community Mental Health Center
Board of Directory, Appointed 1982, Part President
Fine Arts Board, City of Miami Beach
Member 1981-1995
Community Relations Board, City of Miami Beach
Member 1995-1997
Miami Beach Commission on the Status of Women, Miami Beach, Florida
Board of. Directory 1997-1998
AWARDS RECEIVED
Unsung Heroine Award City of Miami Commission on Status of Wornen
1995
Key to the City of Miami Beach Presented by Mayor, 1994
EDUCATION
Rollins College Winter Park, Florida, Bachelor of Arts
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