Karen FrydM IA M I BEACH D 'f»
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.741
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OFFICE OF THE CITY CLER
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH AND THE COMMITTEE
FOR QUALITY EDUCATION IN MIAMI BEACH
As a voting member of the Committee for Quality Education in Miami Beach, I am in
compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4) and
2-190.137 as:
~ am a City of Miami Beach resident for six months or longer.
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D I am the parent/guardian of a student attending a Miami Beach school for the school
year.
School: _
Under penalties of perjury, I declare that I have read the foregoing document and that the facts
stated in it are true.
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Signature
[res-. Fl Date
Printed Name