Loading...
Rob Polishook Application PackagePolishook Rob Last Name First Name Middle Initial 6103 Aqua Ave, 103 Miami Beach Home Address City FL 33141 State Zip Code 97372303149737230314 HomeWork rob@insidethezone.com Email Address 9737230314 Cellular Miami Beach Business Address 6103 Aqua Avenue, #103 City FL State 33141 Zip Code Inside The Zone Sports Perfromamce Group, LLC Occupation:Business Name: Founder/Owner 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: Choice 2: Choice 3: Parks and Recreational Facilities Board BOARD AND COMMITTEE APPLICATION FORM Note:If applying for the At-Large position of the Historic Preservation Board, please answer the below questions: Have you ever resided in one of the City's Historic Districts for at least one year?No No Address in City Historic District submitted. Professional License License Number Issuance Date Expire Date Robert Polishook P422760602980 5/20/2021 8/19/2029 Note:If you are seeking appointment to a professional seat (e.g. attorney, architect, etc.), you must attach a copy of your currently effective corresponding professional license. Pursuant to City Code section 2-22(4) a, b and c: Members of Agencies, Boards, and Committees shall be affiliated with the city. This requirement shall be fulfilled in the following ways: YesResident of the City for a minimum of six (6) months: Demonstrate an ownership interest in a business established in the City for a minimum of six (6) months:No AFFILIATION WITH THE CITY OF MIAMI BEACH a. ● I am resident of:North Beach Or b. "Ownership Interest" shall mean the ownership of ten percent (10%) or more (including the ownership of 10% or more of the outstanding capital stock) in a business. "Business" shall mean any sole proprietorship, sponsorship, corporation, limited liability company, or other entity or business association. c.Full-time employee of such a business (for a minimum of six months); and I am based in an office or other location of the business that is physically located in Miami Beach (for a minimum of six months):No Notwithstanding the requirements set forth herein, the qualified full-time employee of a business must be approved by a 4/7th vote of the Mayor and City Commission. NOTE: Members of Agencies, Boards, and Committees shall be required to demonstrate compliance with the City affiliation requirements of section 2-22 (4) a and b of the Miami Beach City Code by executing an affidavit, stipulating that they have met either (or both) of said affiliation requirements. The original affidavit shall be filled with the Office of the City Clerk prior to being sworn in as a member. Or No● Have you ever been convicted of a felony: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? ● Are you presently a registered lobbyist with the City of Miami Beach?No ● I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: I am a mental training coach: work with athletes in all sports. Adjunct professor: Seton Hall University, teach a case studies class in Sports Psychology Tulane University: Deans Advisory Committee Author of three books All of these opportunities have helped me understand the importance of listening, being empathetic, and transparent with people. I regularly play Tennis, Pickleball, and Beach Tennis at all the Miami Beach facilities, and have a strong understanding of the current environment I am curious, love to inspire people and always looking to learn and apply best practices to anything i do. 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 board/committee you have served on for period of one year after leaving office (Miami Beach Code section 2-26) o Requirement to disclose certain financial interests and gifts (Miami-Dade County Code section 2-11.1). 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 equality to members of advisory and non-advisory bodies who are presented with a voting conflict of interest under Section 112.3143. Florida Statutes. ● In what organization(s) in the City of Miami Beach do you currently hold membership in? No Organization Information Submitted. ● List the address of all properties owned or in which you have an interest within the City of Miami Beach: Property Rob Polishook 6103 Aqua Road, #103, Miami Beach, FL 33141 If so, which department and title?No● Are you now employed by the City of Miami Beach: ● Pursuant to City Code Section 2-25 (b): Do you have a parent, spouse, child, brother, or sister who is employed by the City of Miami Beach?No If "Yes", identify person(s) and department(s): No relative's information submitted. BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATEMENT Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami-Dade County Financial Disclosure Code Section 2-11.1(i)(2) 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. One of the following forms must be filled 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;" or 2. A "Statement of Financial Interests (Form 1)¹ ;" or 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. _____________________________ ¹ Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida, pursuant to F.S. §112.3145(1)(a), to file a Statement of Financial Interests (Form 1) with the Miami-Dade County Supervisor of Elections by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their Form 1 with the County Supervisor of Elections automatically satisfy the County’s financial disclosure requirement as a Miami Beach City Board/Committee member and need not file an additional form with the Office of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State requirement. DIVERSITY STATISTICS REPORT The following information is voluntary and has no bearing on your consideration for appointment. It is being asked to comply with City diversity reporting requirements. WhiteRace/Ethnic Categories What is your race? No details providedOther Description: Gender:Male Are you Spanish/Hispanic/ Latino? Mark the "No" box if not Spanish / Hispanic / Latino.No Physically Challenged:No UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING APPLICATION AND THAT THE FACTS STATED IN IT ARE TRUE. ADDITIONALLY, I AGREE AND ACKNOWLEDGE THAT ANY FALSE STATEMENTS OR FALSE INFORMATION SUBMITTED AS PART OF THIS APPLICATION SHALL BE A BASIS FOR MY REMOVAL FROM A CITY BOARD OR COMMITTEE. 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 CITY, COUNTY, AND/OR STATE LAWS AND STATUTES ACCORDINGLY. I Rob Polishook agreed to the following terms on Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date Board and Committee Application Checklist: Please ensure you have provided all information before applying or reapplying to any Board and Committee. YES YES YES YES I have answered all questions fully. I have uploaded a current resume, photograph, and a copy of any applicable professional license. I have completed and attached the Board & Committee Financial Acknowledgment Statement. I have completed and attached the Diversity Statistics Report. If you have any questions, please contact the Office of the City Clerk via email: BC@miamibeachfl.gov or telephone: 305.673.7411 Note: Florida Statutes 119.071: The role of the Office of the City Clerk is to receive and maintain forms filed as public records. If your home address, telephone numbers, and/or photograph are exempt from disclosure and you do not wish your home address, telephone numbers, and/or photograph to be made public, please: 1) Use your office or other address for your mailing address; 2) Use your office or other telephone number for your contact number; and 3) Do not attach a photograph. Bio- Rob Polishook Rob Polishook, M.A., C.P.C., is the founder and director of Inside the Zone Sports Performance Group, LLC. As a mental training coach, he works with athletes and teams from junior players to professionals, helping them to uncover their mental edge—often the difference between winning and losing. He specializes in helping athletes overcome performance blocks (i.e. yips, chokes, slumps, anxiety), helping athletes work through the “unspoken” psychological trauma from injuries, helping already high-performing athletes reach beyond self-imposed barriers, and teaching innovative mental training skills, tools, and techniques. Rob’s non-judgmental manner encourages athletes to work with performance issues using awareness, acceptance, and brain/body intuition. This unique inside-out approach encourages empowerment and trust in self and the process. Rob’s focus is on the athlete as a person first and a performer second which he coined Whole Human Athlete. Through this lens he recog- nizes that day-to-day, on and off-the-course experiences directly impact how an athlete per- forms especially under pressure. Rob has presented workshops in India, Israel and the United States. Annually, He runs week- long workshops called “Tennis Inside the Zone- the journey beyond the score” at the highly ac- claimed Omega Institute. He is the author of three books (Tennis, Golf, and Baseball Inside the Zone- mental training workouts for champions). Additionally, his articles have been published nationally with USTA, USPTA and NY/LI Tennis Magazine. He has been quoted in Sports Illus- trated, NY Times and other publications. He has also been featured in interviews with ESPN radio and featured in Fields of Fear The Macky Sasser story a 30 for 30 ESPN documentary. Rob has earned a Masters degree in psychological studies with a concentration in sport and ex- ercise psychology from Seton Hall University (SHU) and has completed his certification in sport psychology from SHU. He has a BA from Tulane University in Marketing (1983). Early in his ca- reer, he worked for Macy’s in their executive training program and left as a buyer, worked at Coach Leatherware as a key account manager and founded and sold a company called Chile To- day-Hot Tamale specializing in spicy foods. He is a certified professional/life coach from IPEC, an international federation coaching affiliate. He has also received certifications in Somatic Ex- periencing, Brainspotting Sports Performance Work, Focusing and Jim Loehr’s Mental Tough- ness Program. Additionally, he is a certified Mindfulness teacher. Rob and his wife Debbie are residents of Miami, FL. He can often found playing tennis at North Shore and all the Miami facilities, Pickleball at MBGC/Polo Park, and Beach Tennis at 73rd street. He loves, follow and participates in most sports involving a racket and regularly attends workshops to further his knowledge. When not working, he can be seen walking his dog Gumbo on Aqua Island and having coffee with his wife Debbie at Sazon, Sunset Harbor or other local coffee, lunch and dinner shops.