Jill R. Shockett Application Package M( M I BOARD AND COMMITTEE APP ATION FORM
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Last Na' e Frst Name Mi dle Initial
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Home Address Ci Sta Zip Code
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Business Name Occupation
Business Address City State Zip Code
Professional License(describe): Expires:
Please attach a copy of currently effective professional license.
Pursuant to City Code section 2-22(4)a&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 I.' II or No
• Demonstrates ownership/interest in a business in /•-mi Beach for a minimum of six months: Yes or No Zji
• Are you a registered voter in Miami Beac . Yes nIl or No La
• I am now a resident of: North Beach South Beach Middle Beach 10
• I a • app king or an .appointment because I hav- sgecia abilit s no edge - d experience Ple• e list blow.
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rL• • / • �%I �- /1 J�' /IAi / ♦ Wit/; %' / •' , W ��y
•Are .0 p esently a registeelo•':
cO Note: If applying for the Youth Center positions of the Parks and Recreations Facilities Board,please indicate your affiliation with
the Scott Rakow Youth Center and/or the North Shore Parks Youth Center:
• Please describe your past service with the City's Youth Centers(include dates of service):
• Present participation in Youth Center activities by your children: Yes No U
If yes, please list below the names of your children,their ages and the programs in which they participate:
Child's name: Age: Program:
Child's name: Age: Program:
• Have you ever been convicted of a felony?Yes or No M. If yes, please explain in detail:
• Do you currently have a violation(s)of City of Miami Beach Code?Yes U]or Nom If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money?Yes or No If yes,explain in detail:
•Are you currently serving on any City Board or Committee?Yes or No 4If yes,which board/committee?
• In what organization(s)in the City of Miami Beach do you currently hold membership?
Name Position
Name Position
• List a properties owned or in w .ch you h..- an interest within the City of Miami Beach:
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•Are you now employed by the City of Miami Beach?Yes 11 or No U
Which department and title?
• Pursuant to City Code Section 2-25 (b): Do you hav a parent [, spouse Li, child D brother 0 or sister who is
employed by the City of Miami Beach?Yes ,Dor No `.V 1
If"Yes,"identify person(s)and 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 omply with City diversity reporting requirements.
Gender: Male La Female
Race/Ethnic Categories
What is your race?
MI African-American/Black
IAA Caucasian/White
f�Asian or Pacific Islander
IZI Native-American/American Indian
Other—Print Race:
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Do you consider yourself to be Spanish,Hispanic or Latino/a? Mark the "No"box if not Spanish, Hispanic, Latino/a.
FAiNo
Yes
Do you consider yourself Physically Disabled?
ni No
Yes
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:
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 the 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).
o 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).
o Sunshine Law - Florida's Government-in-the-Sunshine Law was enacted in 1967. Today, the Sunshine Law regarding open
government can be found in Chapter 286 of the Florida Statutes. These statutes establish a basic right of access to most
meetings of boards, commissions and other governing bodies of state and local governmental agencies or authorities.
o Voting conflict—Form 8B is for use by any person serving at the county, city or other local level of government on an appointed or
elected board, council, commission, authority or committee. It applies equally to members of advisory and non-advisory bodies
who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes.
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 I HAVE RECEIVED, READ AND
WILL ABIDE BY CHAPTER 2, ARTICLE VII, OF THE MIAMI BEACH CITY CODE, ENTITLED "STANDARDS OF CONDUCT FOR
CITY OFFICERS,EMPLOYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND
STATUTES ACCORDINGLY."
a I 1
Appli�:nt's Si nature \ D Name of Applican (PLEASE RI)
Received in the City Clerk's Office by: eea,-4/
3 5 aA
Name of Deputy Clerk Control No. ate
PLEASE ATTACH A CURRENT RESUME, PHOTOGRAPH AND A COPY OF ANY
APPLICABLE PROFESSIONAL LICENSE.
ATTACH ADDITIONAL SHEETS, NECESSARY,IF NECESSARY TO PROVIDE REQUIRED
INFORMATION.
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1
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.miamibeachfl.gov
CITY CLERK'S OFFICE CityClerk @m lam ibeachfl.gov
Telephone: 305.673.7411 Fax: 305.673.7254
Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami-
Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) (2)
Board Member's Name: s/ t Q5 D A E
I understand that no later than July 1, of each year all members of Boards and Committees of the City of
Miami Beach, including those of a purely advisory nature, are required to comply with Miami-Dade County
Financial Disclosure Requirements. This means that the members of City Advisory Boards, whose sole or
primary responsibility is to recommend legislation or give advice to the City Commission, must file, even
though they may have been recently appointed.
One of the following forms must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive,
Miami Beach, Florida, no later than 12:00 noon of July 1, of each year.
1. A"Source of income Statement"
2. A "Statement of Financial Interests (Form 1)"
3. A Copy of your latest Federal Income Tax Return
Failure to file one of these forms, pursuant to the Miami-Dade County Code, may subject the person to a fine
of no more than $500, 60 days in jail or both.
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Signature / ft / "ate
Updated:Tuesday,January 06,2015
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F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx
Jill Shockett
1570 Bay Drive
Miami Beach Florida 33141
305.321.0001 • jillshockett@yahoo.com
OBJECTIVE
To obtain a position that will maximize 30 years of experience gained in innovative event
planning and resourceful leadership.
QUALIFICATIONS
• Maturity and highly developed interpersonal skills
• Knowledge of the local market and business leaders
• Ability to develop pilot projects and manage customer expectations
• Motivation and an unparalleled capacity for planning,organization,and execution
PROFESSIONAL EXPERIENCE
Independent Event Coordinator
Children's Cancer Caring Center's Holiday Party (1984-present)
• Recruit sponsors, solicit donations, and coordinate entertainment for day-long event.
Private Party Planning(1982 -2010)
• Executed weddings on the beach, quinceaneras,bar and bat-mitzvahs, birthday,
graduation , anniversary parties, and yacht parties for various clients.
City of Miami Beach Events(1983-1992)
• Directed and produced community festivals, concerts, and charity benefits, consistently
attracting 3,000-12,000 people.
• Managed public relations, oversaw marketing, and acquired financial sponsorships for
all events.
Adam Productions Event Planning Coordinator(2002 - present)
• Planned over twenty corporate conventions, coordinating between 1,000-10,000
participants per event.
• Managed employee, catering, and production logistics for the Miami Dade College
Graduation.
Indian Creek Private Club Assistant Event Coordinator(2009-2010)
• Organized upscale,multifaceted parties.
Exhibitor for the The Electrolytic Technologies Corporation (1995-present)
• Represent The Electrolytic Technology Corporation at national conventions.
Allied Stores Executive-Buyer and Manager(1978-1981)
• Managed Women's Designer Clothes, Fine and Costume Jewelry, Bridal and Fur
Departments in Jordan Marsh Stores.
• Participated in the Executive Training Program.
NON-PROFIT LEADERSHIP AND INVOLVEMENT
The Samuel Scheck Hillel Community Day School
• Chairwoman, PTA Luncheon, 2003
• Coordinated weekly educational speakers and demonstrations
• Cosmetic technician,hair and costume designer for the Children's Theatre Groups 2010-
2004
• Developed and managed the"Scared Straight Series"2006/7&2005/6
•
2005-2006 Drug-Free Youth In Town "Parent of the Year" (DFY-IT)
2000-2004 PTA Leadership Award at George W. Carver International Baccalaureate Magnet
Middle School
2004-2003 Educational Excellence School Advisory Council Award
2000-1999 Miami-Dade County Outstanding School Volunteer Award in the Adult Category
2004 -1994 PTA Staff Leadership Award
1999-2001 JC Penney Golden Rule Award, a national award
1998 The National PTA Lifetime Member Award recipient
1996-99; 2002-04 Miami Dade County PTA Distinguished Leadership and Volunteer Award
1995-97; 2002-04 Miami Herald School Volunteer Award
1986 The Miami Country Day School Award of Excellence
1991 The Miami Country Day School Michael J.Franco Upper School Award
1985-1994 Miami Beach Proclamations
1985-1994 Miami Beach Key to the City
1985-1994 Miami Beach Medallion
Miami Beach Women's Committee Honoree
1988 Miami Beach Board of Realtors, In Recognition of"Efforts to Make Miami
Beach Better"
1988 Rotary International: "Rotary Club Award"for leadership and dedication in the
rebirth of Miami Beach
1988 Miami Beach Chamber of Commerce Award `Event Origination, Production,
Direction for Miami Beach'
1987-1988 Deed Club Cancer Clinic Golden Deed Dears Award
1987 United Cerebral Palsy Leadership and Dedication Award
1986 Miami Beach Development Corporation for"Outstanding Achievement in the
Economic Enrichment and Rebirth of Miami Beach"
Board Memberships:
2005-present Member of the Board of`Drug Free Youth in Town' (DF-YIT)
2004-2011 Member of the Board of Governors, Samuel Scheck Hillel Community Day
School
1996-1991 Member of the Board of the Fundraising Committee for Miami Country Day School
1994-2004 Member of the Board for the Educational Excellence Advisory Council for the
Magnet International Baccalaureate Programs at the North Dade Center for Modern
Languages, Sunset Elementary School and the George W. Carver Middle School
1985-present Member of the Board, Children's Cancer Caring Center
,