Gloria Salom Application PackageMIAMI BEACH
SAWN
Last Name
Home Address
31c B (QS- \ 2:g
Home Telephone Work Telephone
Business Name
S 1 i A watt. a-. F oo(Zb.,
Business Address
Professional License (describe):
Loci-
First Name
i PN1Jit C aNC-4t A
City
`3i0'S t'11CADQ3ci
Cellular Telephone
BOARD AND COMMITTEE APPLICATION FORM
State
Middle Initial
31y\
Zip Code
QtsfkLbYkk
Email address
f`Q L erdirem
Please attach a copy of currently effective professional license.
Occupation
City
State
Expires:
33110
Zip Code
3\311 20 ki
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. r-
• Resident of Miami Beach for a minimum of six (6) months: Yes fLor No
• Demonstrates ownership/interest in a business in Miami Beach for a minimum of six months: Yes Zor No I��
• Are you a registered voter in Miami Beach: Yes .`! or No
• I am now a resident of: North Beach South Beach Middle Beach
• 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 L1 or 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 Office of the City Clerk.
❑ Affordable Housing Advisory Committee
❑ Health Advisory Committee
❑ Parks and Recreation Facilities Board 0O
❑ Art in Public Places Committee
❑ Audit Committee
❑ Health Facilities Authority Board
0 Personnel Board
0 Board of Adjustment **
❑ Hispanic Affairs Committee
0 Historic Preservation Board*
0 Planning Board"*
❑ Police Citizens Relations Committee
0 Budget Advisory Committee
0 Committee on the Homeless
0 Housing Authority
❑
forQuality Ed tn MB
ommittee uca ion i
'Convention Center Advisory Board
0 Production Industry Council
❑ Human Rights Committee
❑ LGBT Advisory Committee
❑ Marine & Waterfront Protection Authority
0 Cultural Arts Council
0 Miami Beach Commission for Women
0 Sister Cities Program
❑ Sustainability Committee
0 Transportation, Parking, & Bicycle -Pedestrian
^ilities Committee
Visitor and Convention Authority Z
0 Design Review Board*
❑ Disability Access Committee
S�Normandy Shores Local Government
Neighborhood Improvement
❑ Youth Commission
* 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 REVISED 06142016.docx
D° 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
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 Za or No! If yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach Code? Yes or Nof 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 Comp�rnlittee? Yes Lor No Zi If yes, which board/committee?
1\z-lk$ t i IN\
• In what organization(s) in the City of Miami Beach do you currently hold membership? c
T• $i 4A-1 eD1 _ C at. toU �tOcYL 4 &C3 4 (k k�L_
Name Position
Name Position
• List all properties owned or in which you have an interest within the City of Miami Beach:
t lc h[ . $- -toia.E bra. .
• Are you now employed by the City of Miami Beach? Yes or No 1,.
Which department and title?
• Pursuant to City Code Section 2-25 (b): Do you have a parent Z1, spouse A, child brother or sister LJ who is
employed by the City of Miami Beach? Yes or No
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 comply with City diversity reporting requirements.
Gender: Male Li Female Ld
Race/Ethnic Categories
What is your race?
African-American/Black
Zi Caucasian/White
Asian or Pacific Islander
11 Native-American/American Indian
Page 2 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06142016.docx
Other— Print Race:
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box if not Spanish, Hispanic, Latino/a.
No
Yes
Do you consider yourself Physically Disabled?
L'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 ABID -Y CHAPTER 2, ARTICLE VII, OF THE MIAMI BEACH CITY CODE, ENTITLED "STANDARDS OF CONDUCT FOR
CITY •} OYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND
ST ■ ,1
„ S absg:JAP.ci.ttv‘.
App cant's Signature Da e Name of Applicant (PLEASE PRINT)
Received in the Office of the City Clerk by: /74,1A-7 (147,Oti //07/d
Name of Deputy Clerk Control No.
Date
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\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06142016.docx
RESUME
NAME GLORIA SALOM
HOME ADDRESS
815 North Shore Drive, Miami Beach, FL 33141
(Resident of Miami Beach, Florida, Since 1974)
Home: (305) 865-1628 Cell: 305 710-6039
EMPLOYMENT AND Beachfront Realty
PROFESSIONAL 517 Arthur Godfrey Rd
ADDRESS Miami Beach, FL 33140
EDUCATION
WORK EXPERIENCE
12/02- Current
1/92-12/02
01
Miami Beach Senior High School
Miami Dade Community College
Business Administration
Beachfront Realty
Licensed Real Estate Agent, Specializing in
Commercial and residential properties. Preparing
Contracts, leases, business transactions. Negotiating
transactions for prospective clients, with Lenders,
Attorneys, Title companies, etc.
Smith & Supraski, P.A.
Administrator, A/R, A/P, Payroll, Payroll Taxes
(940), Bank Reconciliations, Billing, Handling
Escrow Accounts,•Trust Accounts, Operating
Accounts, Money Market Accounts, Property
Management, Daily Banking, WP5.1, etc., Supervise
and train personnel, Trouble shooting, Maintain
personnel records. Perform all office related duties.
:
10/85-12/88
"`Kirsh, Gidneya fd oTnpan :P.A's
A/R, A/P, Bank Reconciliations, Income Tax
Preparations, Payroll, Daily Banking, Write up
Payroll Taxes, Sales Taxes, UTC -6, W -2's, 940,
941, etc. General Ledger Entries, Financial
Statements.
Ress, Gomez, Rosenburg, Howland and Mintz, P.A.
A/R, A/P, Pension Trust, Profit Sharing, Mortgage
Investments, Bank Reconciliations, Payroll, Payroll
Taxes, Federal and State Reports, Purchasing
Professional and Group Insurance, Interviewing,
Hiring and Training Staff, Daily Banking, Client
Screening.
Gloria Salom
COMMUNITY
MEMBERSHIPS
Volunteered Miami Beach Optimist Club
Baseball Mom for over 9 Years with Miami Beach
Sharks Baseball Travel Team
Baseball Mom for Florida Diamond Pros Baseball
Showcase Team
Volunteered for the University of Alabama Baseball
Diamond Dolls
Afisag-Beach Youtireenter Advisory£ #ee ..
(1993- 2009)
City Of Miami Beach Young Professionals
(1993)
Mount Sinai — Society Member
Jackson Memorial — Golden Angels
Honey Shine
Miami Children's Hospital
Project New Born
LANGUAGE Fluent in Spanish, Serbian (former Yugoslavia) and
some French
OTHER INTERESTS Crafts, Family Vacations, Sports, Landscaping,
Baking.
PROFESSIONAL
REFERENCES
Available Upon Request
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