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M I AM 1 BEACH CITY OF MIAMI BEACH
BOARDS AND COMMITTEE APPLICATION FORM
NAME: vv\ 4 \A - v
Last Name First Name Middle Initial
HOME ADDRESS: Lt4 ' ` �\ �c •^^�� 1 33' 4 v
No. Street City State ip Code
PHONE: (0 SI1 t 36A;72 3c. Vk ct +/11
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 or No ❑
• Demonstrate an ownership /interest in a business in Miami Beach for a minimum of six (6) months: Yes 'or No LI
• Are you a registered voter in Miami Beach: Yes or No ❑
• (Please check one): I am now a resident of: North Beach ❑ South Beach ❑ Middle Beaci>
• I am applying for an appointment because I have special abilities, knowledge, experience. Please list below:
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] 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 ❑ Housing Authority*
❑ Beach Preservation Board ❑ Loan Review Committee*
❑ Beautification Committee ❑ Mayor's Green Ad -Hoc Committee
NA Board of Adjustment* ❑ Marine Authority*
❑ Budget Advisory Committee ❑ Miami Beach Cultural Arts Council
❑ Committee on Homeless ❑ Miami Beach Commission on Status of Women
❑ Committee for Quality Education in MB ❑ Miami Beach Florida Sister Cities
❑ Community Development Advisory* ❑ Normandy Shores Local Gov't Neigh. Improvement
❑ Community Relations Board ❑ Oversight Committee for General Obligation Bond
❑ Convention Center Advisory Board ❑ Parks and Recreation Facilities Board
❑ Debarment Committee ❑ Personnel Board*
❑ Design Review Board* 2, Planning Board*
❑ Disability Access Committee ❑ Police Citizens Relations Committee
❑ Fine Arts Board ❑ Production Industry Council
❑ Golf Advisory Committee ❑ Public Safety Advisory Committee
❑ Health Advisory Committee ❑ Safety Committee
❑ Health Facilities Authority Board ❑ Transportation and Parking Comr 0 #- Q S, M ? 13 A110
❑ Hispanic Affairs Committee ❑ Visitor and Convention Authority*
❑ Historic Preservation Board* ❑ Youth Center Advisory Board 60 :S Wd 8 1 AVW 110Z
* Board Required to File State Disclosure form
C: \Documents and Settings \compurbm \Local Settings \Temporary Internet Files \OLK1C5 \BC Application Revised July 18 2007.doc
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 Board: Yes ❑ No ❑, Years of Service:
2. Present participation in Youth Center activities by your children Yesi_a No D. 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 pit If yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes ❑ or No>& If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: Yes Li or No [. If yes, explain in detail
• Are you currently serving on any City Boards or Committees: Yes ❑ or No If yes; which board?
• What organizations in the City of Miami Beach do you currently hold membership in?
Name: Title:
Name: Title:
• List all properties owned or have an interest in, which are located within the City of Miami Beach:
9 \micAck,, f),(0-,---- \No), k_
• 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 H, spouse child ❑, brother r_;, or sister i 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: Maley Female ❑
Ethnic Origin (Check one)
White, African - American /Black ❑ Hispanic: ❑ Asian or Pacific Islander ❑ American Indian or Alaskan Native 0
Employment Status: Employed 0 Retired ❑ Home -maker 0 Other ❑
"1 hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2,
Article VII o i e City Code "Standards of Conduct for City Officers, Employees and Agency Members."
, "0-- 416 h , ,4- 7;1
• ic= nt's ignature Date Name of Applicant (PLEASE PRINT)
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
K Name of Deputy Cle / �1
Document Control Number (Assigned by the City Clerk's Office) Entered By Date 7 Rev sed 1/25/07 Jo
4
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C: \Documents and Settings \compurbm \Local Settings \Temporary Internet Files\OLK1C5 \BC Application Revised July 18 2007.doc
Avi Ciment
4480 Meridian Ave
Miami Beach, FI USA 33140
Tel: 305- 672 -8119
Cell: 305 - 720 -0671
Fax: 305 - 672 -3012
aciment @aol.com
OBJECTIVE
To obtain a position on the Zoning Board of Miami Beach
WORK EXPERIENCE
Beth Israel Congregation, Miami Beach, FI USA 2008 -2010
Board Member
Spearheaded fundraising campaign to remodel facility.
Jeweler's Choice, Miami Beach, FI USA 1993 — 2011
Manager
Managed All Sales and Purchasing for Jewelers Choice, Inc a retail store established in 1976.
NBV. Corp, North Bay Village, FI USA 2005 -2011
Property Manager
Handles all aspects of Commercial Property Management.
Beachfront Realty, Miami Beach, FI USA 2008 -2011
Sales Agent
David Gray and Associates, Miami Beach, FI USA 1997 -2010
Sales Agent for Life and Health Insurance
EDUCATION
Yeshiva University Miami Beach, FI USA 1990 -1993
Bachelors Degree in Psychology
Hebrew Academy Miami Beach, FI USA 1976 - 1989
SKILLS
Contracted by HBO to sing for the Sopranos Premiere on South Beach, as well as headlined at
the Fontainbleau, Eden Roc, and Miami Beach Resort.
PERSONAL
I am a 39 year old, married father of five children, who was born in Miami Beach and believe I
can be an asset in working towards building an even better Miami Beach.
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Avi Ciment
4480 Meridian Ave
Miami Beach, FI USA 33140
Tel: 305 - 672 -8119
Cell: 305 - 720 -0671
Fax: 305 - 672 -3012
aciment @aol.com
OBJECTIVE
To obtain a position on the Zoning Board of Miami Beach
WORK EXPERIENCE
Beth Israel Congregation, Miami Beach, FI USA 2008 -2010
Board Member
Spearheaded fundraising campaign to remodel facility.
Jeweler's Choice, Miami Beach, FI USA 1993 — 2011
Manager
Managed All Sales and Purchasing for Jewelers Choice, Inc a retail store established in 1976.
NBV. Corp, North Bay Village, FI USA 2005 -2011
Property Manager
Handles all aspects of Commercial Property Management.
Beachfront Realty, Miami Beach, FI USA 2008 -2011
Sales Agent
David Gray and Associates, Miami Beach, FI USA 1997 -2010
Sales Agent for Life and Health Insurance
EDUCATION
Yeshiva University Miami Beach, FI USA 1990 -1993
Bachelors Degree in Psychology
Hebrew Academy Miami Beach, FI USA 1976 - 1989
SKILLS
Contracted by HBO to sing for the Sopranos Premiere on South Beach, as well as headlined at
the Fontainbleau, Eden Roc, and Miami Beach Resort.
PERSONAL
I am a 39 year old, married father of five children, who was born in Miami Beach and believe I
can be an asset in working towards building an even better Miami Beach.
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