Roberta Gould (2) _ 1
M�AM� � CIT 7 L9F€�ll�I B .P'iL 3-1 BOARD AI D'CONIN T 'EE APPLICATION FORiM.
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Last Name First Name . Middle Initial
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Home Address �� 3 �3 � City State Zip Code �
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Home Telephone Work Telephone Cellular Telephone mail address
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Business Name
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Busindss Address 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
for a minimum of six months.
• Resident of Miami Beach for a minimum of six (6)months: Yes In or No
• Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six months: Yes U or No
•Are you a registered voter in Miami Beach: Yesu or No ZI
• I am now a resident of: North Beach ID South Beach U Middle Beach In
• 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 Ljor No
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)
❑Affordable Housing Advisory Committee ❑ Fine Arts Board ❑ Normandy Shores Local Government
Neighborhood Improvement
❑Art in Public Places Committee ❑Gay, Lesbian, Bisexual and Transgender ❑Parks and Recreation Facilities Board
Enhancement Committee GLBT
❑Beautification Committee ❑Golf Advisory Committee ❑ Personnel Board
Board of Adjustment* ❑ Health Advisory Committee ❑ Planning Board*
❑Budget Advisory Committee ❑Health Facilities Authority Board ❑Police Citizens Relations Committee
❑Capital Improvements Projects ❑Hispanic Affairs Committee ❑Production Industry Council
Oversight Committee
❑Committee on the Homeless ❑ Historic Preservation Board ❑Safety Committee
❑Committee for Quality Education in MB ❑ Housing Authority ❑Single Family Residential Review Panel
❑Community Development Advisory ❑Loan Review Committee ❑Sustainability Committee
❑Community Relations Board ❑Marine Authority ❑Tennis Advisory Committee
❑Convention Center Advisory Board ❑Miami Beach Commission for Women ❑Transportation and Parking Committee
❑ Debarment Committee ❑Miami Beach Cultural Arts Council ❑Visitor and Convention Authority
❑ Design Review Board* ❑Miami Beach Human Rights Committee ❑Youth Center Advisory Board
❑ Disability Access Committee ❑Miami Beach Sister Cities Program ❑Waterfront Protection Committee
*Board Required to File 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 Board:Yes I.J No U Years of Service:
2. Present participation in Youth Center activities by your children Yes E_:1 No IZI 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:
F:\CLER\$ALL\cF0RMS\B0ARD Ai'-4D C01MM1TTE'CS\BC Application.doc .
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•Have you ever been convicted of a felony:Yes or No 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 D or No If yes,explain in detail
•Are ou currently serving on any Cit Boards or Committees:Yes or No U. If yes;which board?
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•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:
• 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 D,spouse D, child D brother or sister 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 federal equal opportunity reporting requirements.
Ethnic Origin: Check one on! 1)
Gender: Male 1:3 Female
White (Not of Hispanic Origin):All persons having origins in any of the original peoples of Europe,North Africa or the Middle East.
African-American/Black (Not of Hispanic Origin):All persons having origins in any of the Black racial 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 persons having origins in any of the original peoples of the Far East,Southeast Asia,the Indian Subcontinent,or
the Pacific Islands. This area includes,for example,China,India,Japan,Korea,the Philippine Islands and Somoa.
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 affi ration or community recognition.
Physically Challenged: Yes D or No
Employment Status: Employed I Retired ID Homemaker ID Other
NOTE: IF APPOINTED,YOU WILL BE REQUIRED TO FOLLOW CERTAIN LAWS THAT APPLY TO CITY BOARD/COMMITTEE
MEMBERS. THESE LAWS INCLUDE,BUT ARE NOT LIMITED TO,THE FOLLOWING:
• Prohibition from directly or indirectly lobbying city personnel(Miami Beach City Code section 2-459).
• Prohibition from contracting with the city(Miami-Dade County Code section 2-11.1).
• 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).
• Requirement to disclose certain financial interests and gifts(Miami-Dade County Code section 2-11.1).
• 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 570.611).
Upon request,copies of these laws 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 "STANDARDS OF CONDUCT FOR CITY OFFICERS,
EMPLOYEES AND AGEItCY�MEMBERS."
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Applicant's Signature Date N e of Applicant(PLEASE PRINT)
Received in the City Clerk's Office by:
Name of Deputy Clerk Control No. Date
RESUME ROBERTA GOULD
I have lived on Miami Beach since June 1973 residing on Normandy Isle,Pinetree Drive and
Sunset Island 1. I was a renter at these locations. July 1976,my husband, Ronald Gould, and I
purchased 6585 Allison Road and have lived there to the present. I am familiar with the
problems that landlords, renters, and homeowners have dealing with changes to different
properties.
My husband's family came to Miami Beach in the late 1930's. First living at 2300 Alton Road
and later at 4800 Alton Road.. My husbands family has a long history of serving on various
religious institutions on Miami Beach and in Miami. Alfred B Rosenstein, my husband's grand
father was a founder and First President of Temple Beth Shalom. Mr. And Mrs. Rosenstein, and
Jack and Miriam Gould, my husband's parents were also original founders of The Douglas
Gardens Jewish Home For The Aged. I now feel it is my time to put something back into the
community.
I have two sons who live on Miami Beach. My eldest is an attorney with Holland&Knight and
he and his family live on Alton Road. My younger son and his wife own and operate an optical
store on 41"street and live on Allison Island.
Please accept this resume as evidence of my qualification to be a member of the Board of
Adjustment
2008-present-Women's Conference Miami Beach-helped plan event
2007-present- Commission for Women Miami Beach
1991 -present Esslinger Wooten& Maxwell Realtors, Miami Beach- Broker Associates -�
Residential Sales,
1985- 1991 Stadler Associates Realtors 7990 Red Road Coral Gables - Broker Associate
Residential Sales
1983- 1985 Procorp Realty Owner and General Manager residential real estate sales.
2 offices, One on 167' street and one on Kendall Dr. 45 agents
1984 Real Estate Brokers License
1982 Real Estate Salesman License
1976-1983 Para legal immigration law firm.
1967-1962 Elementary School teacher, Pearl River,New York
1959-1962 Finch College BA degree