Stephen Fox, Jr. Application PackageCITY OF MIAMI BEACH
BOARD AND COMMITTEE APPLICATION FORM
Fox, Jr.StephenM
NAME:
First Name
Last Name
Middle Initial
Florida33139
HOME ADDRESS
:
1350 Pennsylvania Ave; Apt 102Miami Beach
Home No./StreetState
Apt No.City
Zip Code
stephenmfoxjr@gmail.com
(786) 361-2467
PHONE
:
WorkEmail Address
Home
Attorney
Business Name:
J.H. Zidell, P.A.
Position:
300 71st St #605
Miami BeachFlorida33141
Address:
State
CityZip Code
Street
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
Yes
No
Yes
circle one): I am now a resident of: South Beach
Seven year resident, gay working professional of Miami Beach, Na
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 Clerks Office.
(Regular Boards of City)
Choice 1:Police/Citizens Relations Committee
Choice 2:Miami Beach Human Rights Committee
Choice 3:
LGBT Advisory Committee
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:
Child NameAgeProgram
Have you ever been convicted of a felony:No If yes, please explain in detail:
No
Do you currently have a violation(s) of City of Miami Beach codeIf yes, please explain in detail:
No
Do you currently owe the City of Miami Beach any money: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 h
NameTitle
Miami Beach Leadership Academy Alumni Treasurer
Association
Miami Beach Leadership Academy Alumni Treasurer
Association
Miami Beach Leadership Academy Alumni Treasurer
Association
List all properties owned or have an interest in, which are loca
I am now employed by the city of Miami Beach:No Which department?
The following information is voluntary and is neither part of yo
being asked to comply with federal equal opportunity reporting r
Gender:Male
Race/Ethnic Categories
What is your race?White
Mark one or more races to indicate what you consider yourself t
Other Description:
Are you Spanish/Hispanic/ Latino? Mark the "No" box if not Spani No
Physically Challenged:No
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 Stephen Fox, Jr. agreed to the following terms on 12/11/2015 5
Received in the City Clerk's Office by:
Name of Deputy Clerk Control No.Date
STEPHEN M FOX JR
1350 Pennsylvania Ave Apt 102
PHONE (786) 361-2467 -
May 2014
May 2010
May 2007
WORK
Plan N
11 2014
e
; e
t 2013
Assess
a
Anti-
t
Jan 2010
t
Wa 2004
Input
Assist
Maintain
Sep 2005
Assist
Assist
2002 2002
Maintain
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Maintain
; WPM 57
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