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Brian Falk Board and Committee application ® CITYOF MIAMI BEACH MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM NAME: FALK BRIAN M Last Name First Name Middle Initial HOME ADDRESS: 1330 WEST AVE.,APT.2110 Miami Beach FL 33139 Apt No. Home No./Street City State Zip Code PHONE: 704-837-4698 786-871-2139 BRIAN.FALK @GMAIL.COM Home Work Fax Email Address Business Name: CENTER FOR APPLIED TRANSECT STUDIES Position: DIRECTOR OF PUBLICATIONS Address: 1023 SW 25TH AVE Miami FL 33135 Street City State Zip Code 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 • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six(6)months: No •Are you a registered voter in Miami Beach: Yes • (Please circle one): I am now a resident of: South Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: Director of nonprofit organization dedicated to urban design,architecture,and community development. •Are you presently a registered lobbyist with the City of Miami Beach? 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) Choice 1: Ad Hoc Committee Centennial Celebration Choice 2: Choice 3: 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: No Years of Service: NA 2. Present participation in Youth Center activities by your children No if yes,please list the names of your children,their ages,and which programs. List below: • Have you ever been convicted of a felony: No If yes, please explain in detail: • Do you currently have a violation(s)of City of Miami Beach codes: No If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money: No If yes, please explain in detail: •Are you currently serving on any City Boards or Committees: No If yes,which board? •What organizations in the City of Miami Beach do you currently hold membership in? • 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: No Which department? NA 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. Gender: Male Race/Ethnic Categories What is your race?Mark one or more races to indicate what you consider yourself to be. White Other Description: Are you Spanish/Hispanic/Latino? Mark the"No"box if not Spanish/Hispanic/Latino. No Physically Challenged: No NOTE: If appointed,you will be required to follow certain laws which 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 Code section 2-26). • 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 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 Agency Members." I BRIAN FALK agreed to the following terms on 10/15/2014 11:29:14 PM 9 9 Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date Brian M. Falk 1330 West Avenue,Apt. 2110 Miami Beach,FL 33139 brian.falk @gmail.com 704/837-4698 PROFILE Director of nonprofit organization dedicated to urban design, architecture,and community development. EXPERIENCE Director of Publications Center for Applied Transect Studies Miami, FL 2008-2012 CATS supports interdisciplinary research,publication,tools,and training for the design, coding,building and documentation of resilient communities. CATS has received grants from the John S. and James L. Knight Foundation and the Kresge Foundation to support the Project for Lean Urbanism,an initiative to allow more people to participate in the building of their homes,businesses,and communities. Departmental Business Manager, Fitzpatrick Institute for Photonics Staff Specialist, Biomedical Engineering Staff Specialist, Financial Services Duke University Durham,NC 2005—2007 Writer, Editor,Editorial Director Charlotte,NC 1994—2004 EDUCATION Nonprofit Management Program Duke University Durham,NC Bachelor of Arts, Communications Appalachian State University Boone,NC