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Cindy Brown Board resumeCITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM BrownCindy NAME: First Name Last NameMiddle Initial FL33162 HOME ADDRESS : 1873 NE 154 StreetMiami Home No./StreetState Apt No.City Zip Code cbrown@mbgarden.org 786.210.0613305.673.7256305.535.8083 PHONE : WorkEmail Address HomeFax Executive Director Business Name: Miami Beach Botanical Garden Position: 2000 Convention Center Miami BeachFL33139 Address: Drive State No. CityZip Code Street Expires: Attach a copy the license Professsional License (describe): Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and committees shall be affiliated requirement shall be fulfilled in the following ways: a) an indi months; or b) an individual shall demonstrate ownership/interest No Yes No North Beach circle one): I am now a resident of:  I am a well established and very active member or the LGBT Commu No 123Please note that only three (3) Please list your preferences in order of ranking [] first choice [] second choice, and [] third choice. choices will be observed by the City Clerk’s Office. (Regular Boards of City) Affordable Housing Advisory CommitteeHousing Authority [3]Art in Public Places CommitteeLoan Review Committee [2]Beautification CommitteeMarine Authority Board of Adjustment*Miami Beach Commission for Women Budget Advisory CommitteeMiami Beach Cultural Arts Council Capital Improvements Projects Oversight CommitteeMiami Beach Human Rights Committee Committee for Quality Education in MBMiami Beach Sister Cities Program Committee on the HomelessNormandy Shores Local Gov’t Neigh. Improvement Community Development AdvisoryParks and Recreation Facilities Board Community Relations BoardPersonnel Board Convention Center Advisory BoardPlanning Board* Debarment CommitteePolice Citizens Relations Committee Design Review Board*Production Industry Council Disability Access CommitteeSafety Committee Fine Arts BoardSingle Family Residential Review Panel [1]Gay, Lesbian, Bisexual and Transgender (GLBT)Sustainability Committee Golf Advisory CommitteeTransportation and Parking Committee Health Advisory CommitteeVisitor and Convention Authority Health Facilities Authority BoardWaterfront Protection Committee Hispanic Affairs CommitteeYouth Center Advisory Board Historic Preservation Board Note : If applying for Youth Advisory Board, please indicate your aff 1. Past service on the Youth Center Advisory Board: No Years of Service: if yes, please list the names of your children, their No 2. Present participation in Youth Center activities by your chil ages, and which programs. List below: Age:Program: Child's name: Age:Program: Child's name: No Have you ever been convicted of a felony:If yes, please explain in detail: Do you currently have a violation(s) of City of Miami Beach code No If yes, please explain in detail: No Do you currently owe the City of Money Beach any money:If yes, please explain in detail: No Are you currently serving on any City Boards or Committees:If yes, which board? What organizations in the City of Miami Beach do you currently h Name:Title: Name:Title: List all properties owned or have an interest in, which are loca No I am now employed by the city of Miami Beach:Which department? Pursuant to City code Section 2-25(b): do you have a relative who is employed by the City of Miami Beach? Check all that apply. Identify the departme The following information is voluntary and is neither part of yo being asked to comply with federal equal opportunity reporting r Gender:Female Ethnic Orgin: Check one only (1) White No Physically Challenged: Employed Employment Status: NOTEIf appointed, you will be required to follow certain laws which :   These laws include, but are not limited to, the following: Prohibition from directly or indirectly lobbying city personnel o Prohibition from contracting with the city (Miami-Dade County Co o Prohibition from lobbying before board/committee you have served o Beach Code section 2-26). Requirement to disclose certain financial interests and gifts (M o (re: CMB Community Development Advisory Committee):  prohibiti from having   any interest in or receiving any benefit from Co or those with whom you have business or immediate family ties Upon request, copies of these laws may be obtained from the “I hereby attest to the accuracy and truthfulness of the applica VII – of the City Code “Standards of Conduct for City Officers, I Cindy Brown agreed to the following terms on 8/30/2012 1:30:12 Received in the City Clerk's Office by:Date: / /2012Control No.Date: / /2012 Name of Deputy Clerk