Marjorie York 12/31/2011m MIAM,BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beoch, Florida 33139, wvow.miamibeachfl.oov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673-7254
12/15/2009
Marjorie York
829 15 Street
Miami Beach, Florida 33139
~l~J~~~ ~__.__~__. Miami Beach Commission For Women
Gongratulations! You have been reappointed by Mayor Matti Herrera Bower
to the above referenced agency, board or committee for a term ending: 12/31/2011.
If you are unable to accept this appointment, please notify the City Clerk's Office at
(305) 673-7411.
Please read the enclosed material carefully. Again, congratulations and good luck.
Sincerely,
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Wanda Ortiz
ATTACHMENTS:
Letter of Appointment
Oath
City Code Ordinance section, applicable to agency, board or committee
City Code Section 2-22, 2-23, 2-24, 2-25, 2-26, 2-2458, 2-459
Ordinance 2006-3543 -Amendment to City Code Section 2-22
Miami-Dade County Code.Section 2-11.1 -Conflict of Interest and Code of Ethics Ordinance
City Wide Permit Application - (Parking Department Form)
Booklet -Guide to the Sunshine Amendment and Code of Ethics for Public Officers and
Employees
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
m MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673-7254
TO Marjorie York
RE: Miami Beach Commission For Women
1 do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Government of the
United States, the State of Florida, and the City of Miami Beach, and to perform all the duties of
a member of the above-mentioned board or committee of the City of Miami Beach to which 1 have
been appointed for a term ending: 12/31/2011.
I have been issued a copy of Section 2-11.1 of the Miami-Dade County Code (Conflict of Interest
and Code of Ethics Ordinance), as well as theF/orida Commission on Ethics Guide to the Sunshine
Amendment and Code of Ethics for Pub/ic Officers and Employees, and understand that as a member
of a City of Miami Beach Board and/or Committee, I must comply with the financial disclosure` require-
ments of Miami-Dade County or the State of Florida (depending on the board or committee on which
I serve) on July 1st, following the closing of the calendar year on which I have served.
~g7`M~arjorie York
Sworn to and subscribed before me thi~i ` day of , 200
• ~%C.C-C
~ a
Silvia Prieto
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachtl.gov under City Clerk/Board and Committees
for additional information regarding the Financial Disclosure Requirements.
We are commiHed to providing excellent public service and sofefy to all who live, work and play in our vibrant, tropical, historic community.
NAME:
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Last Name
HDME ADDRESS:
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. First Name
~viiddle Initial
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2D Apt No.' 6 ~ 3 `~~ ~Nyo~$eet City / State Zip Code
PHONE: / ~ G
Home Work Fax Email address
Business Name: -Position:
Address:
No. Street City ,State Zip -Code
Professional License (describe) ~ Expires: Attach a copy of the license
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/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 0 or No D
• Demonstrate an ownershiplinterest in a business in Miami Beach for a minimum of six (6) months: Yes ^ or No ^
• Are you a registered voter in Miami Beach: Yes D or No D
. (Please circle one): I am now a resident of: North Beach South Beach Middle Bsach
. I am applying for an appointment because I have special abilities, knowledge and experience. Please list below:
. Are you presently a registered lobbyist with the City of Miami Beach? Yes ^ or No D
Please list your preferences in order of ranking [1J first choice [2J second choice, and [3j third choice. Please note that only three (3)
choices will be observed by the City Clerk's Office. (Regular Beards of City)
D Affordable Housin Adviso Committee D Housin Autho '
^ Art in Public Places Committee D Loan Review Committee
D Beautification Committee D arine Autho
D Board of Ad'ustment' Miami Bsach Commission for Women
D Bud Adviso Committee D Miami Beach Cultural Arts Councl
D C Itel Im rovemerrts Pro acts Oversi ht Committee D Miami Beach Sister Cities Pro ram
p Committee on the Homeless D Normand Shores Local Govemmerrt Nei h. Im rovement
D Committee for Qua(' Education in MB D Parks and Recreation Facilities Board
D Commun' Deveio ment Adviso ^ Personnel Board
D Commun Relations Board D Plannin Board''
D Convention Center Adviso Board D Police Citizens Relations Committee
^ Debarment Committee D Production Indu Council
D Desi n Review Boar+d* ^ Public 5a Adviso Committee
D Disabif' Access Committee D Sa Committee
D Fine Arts Beard D Sin le Famii Residential Review Panel
D Ga ,Lesbian, Bisexual and Trans ender GLBT ^ Sustainabil' Committee
^ Golf Adviso Committee D Trans aren Reliabil' & Accountabii' Committee "TRAC"
D Health Adviso Committee D Trans ortation and Parkin Committee
D Health Facilities Autho ' Board ^ Visitor and Convention Autho '
D His anic Affairs Committee ^ Watertront Protection Committee
D Historic Preservation Board D Youth Center Adviso Board
"Board Required to Fife State Disclosure Form
Note: if applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center:
1. Past service on the Youth Center Advisory Beard: Yes 0 No ~ Years of Service:
2. Present participation in Youth Center activities by your children YesL~ No D. If yes, please
ages, and which programs. List below:
Child's name: Age: Program:
Child's name:
Age: Program:
CfTY Or MI;;MI BEACH
E tiPPLICATION t=ORM
list the names of your children, their
F:\CLEP.`.~ALL\aF~RMS\BOARD AND COMMITTEES\eC Application052b09 rlEW.do:
.Have you ever been convected of 2 felony: Yes : >~"Fl'o . I` yes. please explain in detail.
• Do you currently have a violation(s) of City of Miami Beach codes: Yes = or' Nino ~. If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: Yes = or Nml~. tf yes. explain it detail
• Are you currently serving on any City Boards ~ Committees: Yesv or No -.. {f yes', which board?
s.
• Wh~ ~ganizations in the City of Miami Beach do you currently hold membership in? - ~~`
Name ~ vr~d~~Gv/L~O/~ y Title: ~'~!
Atame:_ e'~'•~~f71,liK~ L~~~i L~TitiP~ ` -r-,-_
all
or
rn,
the Cify of Miami Beach:
• I am now employed by the City of Miami Beach: Yes G or No~Which department?
• Pursuant to City Cade Section 2-25 (b): Do you have a parent 0, spouse C, child G: brother C, or sister D who is employed by the
City of Miami Beach? Check all that apply. Identify the department(s):
The following information is voluntary and is neither part of your application nor has any bearing on your consideration for appointment. It is
being asked to comply with fe~dera/l equal opporWnlty reporting requirements.
Gender: D Male `O'FemaVe
m: t;necic one only (~}
~ White (Not of Hispanic Origin): All persons having origins in any of the original peoples of Europe, North Africa or the Middle East.
^ African-AmertcanJBlack (Not of Hispanic Origin): All persons having origins in any of the Black raaal groups of Africa.
^ Hispanic: All persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.
^ Asian or Pacific islander: All parsons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, on
the Pacific islands. This area includes, for example, China, fntfia, Japan, Korea, the Philippine (stands and Samoa.
D American Indian or Alaskan Native: All persons having origins in any of the original peoples of North America, and who maintain
Cultural identification through tribal afffliafion or community recognition.
Yes D or Noel.
Employment Status: Employed D Retired D Homemaker 0 OtheR~
NOTE: tf appointed, you will be required to follow certain caws which apply to city boardicommtttee membees
These taws include, but are not fimttad to, the following:
o Prohibition from directly or indirectly lobbying city personnel (Miami Beach City Code section 2-459}.
o Prohibition from contracting with the city (Miami-Dade County Code section 2-11.1).
o Prohibition from lobbying before board/committee you have served on for period of one year after leaving office (Miami
Beach City Code section 2-26).
o Requirement to disclose certain financial interests and gifts (Miami-Dade County Code section 2-11.1).
(re: CMB Community Development Advisory Committee): prohibition, during tenure "and for one year after leaving office,
from having any interest in or receiving any benefit from Community Development Block Grant funds for either yourself
or those with whom you have business or immediate family ties (CFR 57D.611}.
Upon request, copies of these Taws may be obtained from the City Clerk.
"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 ~St~ndar~s of Conduct for City Officers, Employees and Ageneq Members."
Please attach a copy of your resume to this application
NaTE: Applications will remain on file for a period of one (1 Y calendar year.
Received rn the City Clerk's Offece by Date _' /2005 control No Date: ~_/ 008
Name of Deputy Clerk -'