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Biritta I. Hanson Application Package ... M I AAA I it EACH • 4,, B BOARD AND COMMITTEE EE APP LICATION FORM IL__04. ,,. . Last Name First Name Middle Initial \o() , 1-e t O, \J Miv ! -_ 33\3 csi Home Address City Zip State Zi Code P 1 i i iNr" \ 'tg 2 (3 g S g ‘47{1 4+,&\rt.A.In 0,1 e mac . (-OM Home Telep`h'one Work Telephone Cellular Telephone ` Email address 1f�C 1-_m. t/J i 1 Business Narrr occupation n P c')0"k"+\ \r0 l 1"4-Zo —‘r 1'.7 f\A . t. . C?r4A,A...--v. w f, ,,,e.:4-17\ g, ea.,,,,z. cit 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: Ye or No Di • Demonstrates ownership/interest in a business in M. .-Beach for a minimum of six months: Yes Eli or Np. • Are you a registered voter in Miami Beach: Y s or No El • I am now a resident of: North Beach El South Beach Middle Beach 1J • 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 Eli or N 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. ❑Ad Hoc Charter Review and Revision Board ❑Debarment Committee _ ❑Miami Beach Human Rights Committee ❑Ad Hoc Committee Centennial Celebration ❑Design Review Board* f ❑Miami Beach Sister Cities Program 0 Ad Hoc Committee Flooding Task Force ❑Disability Access Committee 0 Normandy Shores Local Government . Neighborhood Improvement 0 Affordable Housing Advisory Committee I' V Fine Arts Board ❑Parks and Recreation Facilities Board rt in Public Places Committee c...4 Gay,Lesbian,Bisexual and Transgender 0 Personnel Board Enhancement Committee(GLBT) 0 Beautification Committee 0 Golf Advisory Committee 0 Planning Board * _ 0 Bicycle-Pedestrian Advisory Committee 0 Health Advisory Committee - ❑Police Citizens Relations Committee ❑Board of Adjustment* ❑Health Facilities Authority Board ❑Production Industry Council ❑Budget Advisory Committee ❑Hispanic Affairs Committee ❑Safety Committee ❑Capital Improvements Projects Oversight 0 Historic Preservation Board 0 Single Family Residential Review Panel Committee ❑Committee on the Homeless ❑Housing Authority ❑Sustainability Committee 0 Committee for Quality Education in MB 0 Loan Review Committee 0 Tennis Advisory Committee ❑Community Development Advisory Committee 0 Marine Authority ❑Transportation and Parking Committee ❑Community Relations Board ❑Miami Beach Commission for Women ❑Visitor and Convention Authority 0 Convention Center Advisory Board ❑Miami Beach Cultural Arts Council ❑Youth Center Advisory Board G ❑Waterfront Protection Committee * Board members are required to file Form 1 -"Statement of Financial Interest"with the State. *If you seek appointment to a professional seat (e.g., lawyer, architect, etc.) on the Board of Adjustment, Design Review Board, Historic Preservation Board or Planning Board, attach a copy of your currently-effectively license, and furnish the following information: Type of Professional License • License Number License Issuance Date License Expiration Date Page 1 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION 46 BOARDS 12-16-2013.doc • 0 0O Note: If applying for Youth Center Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: 1. Past service on the Youth Center Advisory Board:Yes No Dates of Service: 2. Present participation in Youth Center activities by your children: Yes Eli No Eli If yes, please list below the names of your children,their ages and the programs in which they participate: Child's name: Age: Program: 1 Child's name: Age: Program: • 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 Code?Yes or N If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money?Yes u1 or No If yes, explain in detail: to Are you currently serving on any City Board or Committee?Yes,14"or No fl If yes,which board/committee? • In what organization(s)in the City of Miami Beach do you currently hold membership? Name Position Name Position • List all properties owned or in which you have an jnterest within the City of Miami Beach: •Are you now employed by the City of Miami Beach?Yes 0i or No Which department and title? / • Pursuant to City Code Section 2-25 (b): Do you have a parent , spouse , child brother or sister El who is employed by the City of Miami Beach? Check all that apply. I 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 co -ply with City diversity reporting requirements. Gender: Male U Female zr Race/Ethnic Categories What is your race? I. _frican-American/Black Caucasian/White Asian or Pacific Islander Native-American/American Indian Ui Other—Print Race: Page 2 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION 46 BOARDS 12-16-2013.doc Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No"box if not Spanish, Hispanic, Latino/a. sue. "E 1 No LD1Yes Do you consider yourself Physically Disabled? /Ad 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, PLOYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND STAT : ACC%,. DINGLY." • w t , /plica'''s ''gi•ature 'late ame of Applicant •SE PRINT) �PLE ) Q / !�Received in the City Clerk's Office by: �" Name of Deputy Clerk Control No. L PLEASE REMEMBER TO ATTACH A CURRENT RESUME, PHOTOGRAPH AND A COPY OF ANY APPLICABLE PROFESSIONAL LICENSE. ATTACH ADDITIONAL SHEETS, IF NECESSARY, TO PROVIDE REQUIRED INFORMATION. Page 3 of 4 F:\CLER\$ALL1aFORMS\BOARD AND COMMITTEES\BC APPLICATION 46 BOARDS 12-16-2013.doc Eli • MIAMI BEACH • City of Miami Beach 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY L ' C ERK S OFFICE CityClerk@miamibeachfl.gov Telephone: 305.673.741 1 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: 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 Juiy 1, of each year. 1. A "Source of Income Statement" For your convenience, the form is attached. The form can also be downloaded at: http://www.miamidade.gov/elections/Library/source of income statement.pdf 2. A "Statement of Financial Interests (Form 1)" For your convenience, the form is attached. The form can also be downloaded at: http://www.ethics.state.fl.us/ethics/forms.html 3. A Copy of your 2013 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. Signature Date • Updated: Monday, December 16,2013 • Page 4 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION 46 BOARDS 12-16-2013.doc 41) Britta Hanson 100 Jefferson Ave. Apt 10008 Miami Beach, Fl 33139 Cell (312) 813-2888 Fine Arts Board I have been very active in the art community in Miami, Chicago, and South America. I have been collecting art since 1987 and served on several boards involving the arts both here and in Latin America. I had a business that worked with indigenous arts in Venezuela, Colombia, Ecuador, Peru, Bolivia, and Brazil from 1990-2004. In Chicago I served on the board of the Aldo Castillo gallery from 2002-2004. I was art director for the Shadows art project and the Children's Art Fundraiser at Temple Beth Schmuel from 2008-10. I was art director for SPE Faces project at the Bass Museum in Miami Beach in 2010 and I also served as Art Director and Curator for the Haiti Expo during Art Basel in 2010. Since 2013 I have acted as one of the artistic directors for One Billion Rising which is a world wide event to stop violence against women. i ► • I currently teach Fine Art and 3D Art at South Pointe Elementary and at North Beach in the enrichment program. I majored in Latin American studies with minors in art and anthropology. f =� x � a ^ti 7 ,1; • V *74,