Ayala MendlowitzMIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach,Florida 33139
OFFICE OF THE CITY CLERK
Email:.BC@miamibeachf]_gov
Telephone:305.673.7411
JAN 16 2025
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
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:
I am a City of Miami Beach resident for six months or longer.
Home Address:']Ly po _D jp [y3__tic_a __L_LL_AL+
[]lam the parent/guardian of a student attending a Miami Beach school for the _LL_A_±_school
year.
School:__@lg_±write.__
D My parent/legal guardian requirement has been waived by the City Commission.
Under penalties of perjury,I declare that I have read the foregoing document and that the facts
stated in it are true.
Signature °
[La_]Lier_it
Printed Name
Date