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Prakash S. Kumarm /v11AMl BEA:~H NAME: Last Name HOME ADDRESS: ~~~ "T ~ Ti~'(`r\~ S ~~"L No. Street PHONE: <~~ ~~ ~ .~5~ AF~D At~D ~..~e~6B T~ APPL.i~`A. ; 1~.~,~1 ~~i'~t r1 S First City Middle Initial F~- 331 State Zip Work Fax ~ Email address Business Name: f ~3>F~ s i >~ ~' ~~ C A C i._ E Position: E ,t., ~•~~.~ _ Address: ~~,~ c=~~}1,''t No. Street City State Zip Code Professional License (describe) Expires: ~~r3wia c ~,-~~- ~= t;a~" F€cerrs~ Pursuant to City Code section 2-22(4) a and 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; orb) an individual shall demonstrate ownership/interest for a minimum of six months in a business established in the city. . Resident of Miami Beach for a minimum of six (6) months: Yes , or No ^ • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (Ei) months: Yes~or No ^ • Are you a registered voter in Miami Beach: Yes .~i or No ^ -------- • (Please circle one): I am now a resident of: North Beach South Beac Middle Beach • 1 am applying for an appointment because I have special abilities, knowledge, experience. Please list below: 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 Citv Clerk's Office. (Regular Boards of City) ~Y' Affordable Housin Adviso Committee ^ Health Facilities Authorit Board ^ Art in Public Places Committee ^ His anic Affairs Committee ^ Beach Preservation Board ^ Historic Preservation Board" ^ Beautification Committee Housin Authorit " ^ Board of Ad~ustment* ' ^ Loan Review Committee'` ^ Bud et Advisor Committee ^ Marine Authorit ^ Ca ital Im rovements Oversi ht ^ Miami Beach Commission for Women Committee on Homeless ^ Miami Beach Cultural Arts Council ^ Committee for Qualit Education in MB ^ Miami Beach Florida Sister Cities ^ Communit Develo ment Adviso ~ ^ Normand Shores Local Gov't Nei h. Im rovement ^ Communit Relations Board ^ Parks and Recreation Facilities Board ^ Convention Center Adviso Board ^ Personnel Board' ^ Cultural Arts Nei hborhood District Overla CANDO ^ Plannin Board ^ Debarment Committee ^ Police Citizens Relations Committee ^ Desi n Review Board" ^ Production Industr Council ^ Disabilit Access Committee ^ Public Safet Adviso Committee ^ Fine Arts Board ^ Safet Committee ^ Ga Business Develo ment Ad Hoc ^ Trans arenc Reliabilit & Accountabilit Committee "TRAC ^ Golf Adviso Committee ^ Trans ortation and Parkin Committee ^ Green Ad Hoc Committee ^ Visitor and Convention Authorit " ^ Health Adviso Committee .. ^ Youth Center Adviso Board .~..o~.. ~~~y.,~~~~ w nee mate uiscivsure rorm ~:iCL.ER1sAL!_1B&C ApplicationlB&C; Application Reviser; 0b1908.doc. 1 Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: 1. Past service on the Youth Center Advisory Board: Yes ^ No G Years of Service: 2. Present participation in Youth Center activities by your children Yes^ No _. If yes, please list the names of your children, their ages, and which programs. List below: Child's name: Age: Program: Child's name: Age: Program: .Have you ever been convicted of a felony: Yes ~ or No If yes, please explain in detail: . Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or No.~. If 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 Boards or Committees: Yes ^ or No C~ If yes; which board? • What organizations in the City of Miami Beach do you currently hold membership in? Name:ii~ ~;.r~ L_c;~a ~ A-.1 xlc.~~.. u ~l.iv~i.~.L Title: ~.'w.~o~.'~ Name:Gcu~v.C rn~~r< N, ~~~s ~1S'~ ~ ~ r :v/t~ Title: P~4.Lw~~JV • List all properties owned or have an interest in, which are located within the City of Miami Beach: ,~-~.r~ • I am now employed by the City of Miami Beach: Yes ^ or No~hich department? • Pursuant to City Code Section 2-25 (b): Do you have a parent ^, sp\\ouse ^, child ^, brother ^, or sister ^ who is employed by the City of Miami Beach? Check all that apply. Identify the department(s): This section is "not required" but desired: Age: ~ years old Gender: Ma~ Female ^ Ethnic Origin (Check one) White ^Rfrican-American/Black ^ Hispanic: ~ sia or Paerfic'1'S1"ander ^ American Indian or Alaskan Native ^ "1 hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2 Article VII - of the City Code "Standards of Conduct for City Officers, Employees and Agency Members." nt's Signature ~ I °~ i ~--~ ~ ~ Name of Applicant (PLEASE PRINT) Please attach a copy of your resume to this application NOTE: Applications will remain on file for a period of one (1) calendar year. Employment Status: Employed ^ Retired ^ Home-maker ^ Other ^ Received in City Clerk's Office by Date Name of Deputy Clerk Document Control Number (Assigned by the City Clerk's Office) Entered By Date Revised 04!18/08 LH F:ICLERi~At_t_\B&C Appiicationi8&C; .~;pplicatioii Revised 051908.doc. PRAKASH S.KUMAR Florida Local Advocacy Council Member The Honorable Mayor, City of Miami Beach, Miami Beach,FL-33139. Respected Madam Mayor, REF:AFFORDABLE HOUSING ADVISORY COMMITTEE MEMBER Miami Beach Neighborhood Leadership Academy as well as the Citizen's Police Academy classes,after completion,inspires me to get involved in all community activities of Miami Beach in particular.As such herein attached is my application with a request to kindly consider and to appoint me as a Board Member of the above committee. Currently I am a Board member- CPNA,I am committed and dedicated,willing to serve the community,provided an opportunity is given to me. Appreciate highly if you consider my application favorably.For further information you may reach me via,e-mail-pakku55@yahoo.com,or cell # 305 803 7759. Sincerely , ~~ >~ (prakash kuma ) ~~~'~~ns enc;2 copy to: Bob Parcher City Clerk,CMB. Miami Beach,Fl-33139. PRAKASH S.KUMAR 1'775,. AMES AVENUE IVIIAI~IT BEACH,FL-33139 E-mail: alp ckLi55~"cr)yahoo.com Cell # 305-803-7759 Activities: Human rights activist- Governor appointee,Florida Local Advocacy council Invol°~ed in Community Dr,velopmental programm~~s,such as-Environmental, Children and Families wel'are,poverty eradication ~ac.,through the NGO'~ Board Member: Collins Park Neighborhood Association, Neighborhood Leadership Academy Alumni Association, Miami International Press Club Member. and Volunteered FEMA /American Red Cross,dw-ing major hurricane -"WILMA". participat~~.d in, Neighborhood Leadership Academy, and N[iami Beach citizen's police Academy # 35, classes. Education: Molds a Law and a SciencF; Degree from MysorcUmversity-India. Age : 62 years General: Owner-Business Circle,Sill~~cs/Linen trade consultant. Othres : With a prime motto-"Service to Humanity is servicE- to God",loves to serve the community at large in various capacities.