Mary KeinathMIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach,Florida 33139
OFFICE OF THE CITY CLERK
Email:BC@miamibeachfl.gov
Telephone:305.673.7411
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH AND THE COMMITTEE
FOR QUALITY EDUCATION IN MIAMI BEACH
As a voting mem ber of the Committee for Quality Educa tion in Miami Beach,I am in complian ce
wi tht he affiliation requirement of Miami Beach City Code Sections 2-22 (4)and 2-190.137 as:
ff 1am a City of Miam i Beach residen t for six months or longer.
too A«so »../0 {e,M,3%3123atheparent/guardian of a student attending a Miami Beach school for the school
year.••M_14$,BE
[]My paren t/legal guardian requirem ent has been waived by the City Commission.
Unde I declare that I have read the foregoing document and that the facts
stat
e ;t)ken2kt
Printed Nam';a-:-
Date