HomeMy WebLinkAboutcls_agenda_packet_20190926 QpCEA O THE
SPACC
BETWEEN°
CULTURE AND LEISURE SERVICES BOARD
REGULAR MEETING
CAPE CANAVERAL CITY HALL
100 POLK AVE
SEPTEMBER 26,2019
5:30 P.M.
AGENDA
CALL TO ORDER:
ROLL CALL:
PUBLIC PARTICIPATION:
Any member of the public may address any items that do not appear on the agenda and any agenda
item that is listed on the agenda for final official action by the Culture and Leisure Services Board,
excluding public hearing items which are heard at the public hearing portion of the meeting,
ministerial items (e.g_, approval of agenda, minutes, information items) and quasi-judicial or
emergency items. Citizens are encouraged to limit their comments to three (3) minutes. The
Culture and Leisure Services Board will not take any action under the "Public Participation"
section of the agenda. The Culture and Leisure Services Board may schedule items not on the
agenda as regular items and act upon them in the future.
ACTION/DISCUSSION ITEMS:
5:45 p.m.—6:30 p.m.
1. Approval of Meeting Minutes—July 25,2018
2. Staff Report—QUESTIONS&COMMENTS ONLY
3. Old Business
4. New Business
Board applicant interviews:
1. Joel Fair
2. Kathryn Parks
Presentation of vacating member's certificates
ADJOURNMENT:
Pursuant to Section 286-0105,Florida Statutes,the City hereby advises the public that: If a person decides to appeal
any decision made by the Culture and Leisure Services Board with respect to any matter considered at this meeting,
that person will need a record of the proceedings,and for such purpose that person may need to ensure that a verbatim
record of the proceedings is made,which record includes the testimony and evidence upon which the appeal is to be
based. This notice does not constitute consent by the City for the introduction or admission into evidence of otherwise
inadmissible or irrelevant evidence,nor does it authorize challenges or appeals not otherwise allowed by law.
In accordance with the Americans with Disabilities Act: all interested parties may attend this Public Meeting. The
facility is accessible to the physically handicapped. Persons with disabilities needing assistance to participate in the
proceedings should contact Patti Roth,City of Cape Canaveral Leisure Services(868-1226)48 hours in advance of
the meeting.
CULTURE AND LEISURE SERVICES BOARD
MEETING MINUTES
JULY 25,2019
A meeting of the Culture and Leisure Services Board was held on July 25,2019,at Cape Canaveral
City Hall, 100 Polk Avenue, Cape Canaveral, Florida. The meeting was called to order at 5:30
p.m. by Chairperson Gene Petre.The Secretary called the roll.
MEMBERS PRESENT
Gene Petre Chairperson
Douglas Raymond Vice Chairperson
Barbara McPeek
Maureen Michel
Mickie Kellum
Tim Bass
Larry Holmes
OTHERS PRESENT
Gustavo Vergara Culture and Leisure Services Director
Patti Roth Board Secretary—Leisure Services
Molly Thomas Cultural Programs Manager
Joshua Surprenant Community Services Director
Approval of Meetinn Minutes of May 30,2019
Motion by Ms.Kellum to approve meeting minutes of May 30,2019 as written—seconded by Ms.
McPeek Vote on the motion carried unanimously.
OLD BUSINESS:
■ Mr.Vergara updated board on the Multi-Generational Facility and Canaveral City Park
Redevelopment project.
■ Mr.Vergara announced upcoming events.
■ Ms Kellum inquired about amenities to be included in Canaveral City Park Redevelopment
and Estuary Park projects.
■ Mr.Petre inquired about counter-vandalism measures at City facilities.
NEW BUSINESS:
■ Mr.Surprenant updated the Board on the department restructuring.
■ Mr.Petre inquired about the 2020 Budget.
ADJORNMENT:
There being no further business,Ms.Kellum made a motion to adjourn—seconded by Ms.Peek.
Vote on the motion carried unanimously and the meeting adjourned at 6:05 p.m.
Approved on this,the 2e day of September,2019.
Gene Petre,Chairperson Patti Roth,Board Secretary
THE
SPACE
C1W OF
y CAPE CANAVERAL B E T W E E N O..
CAPE CANAVERAL CULTURE AND LEISURE SERVICES
ADVISORY BOARD STAFF REPORT
SEPTEMBER 26, 2019
Copied from Weekly Updates 07/22/2019- 09/16/2019
No updates September 2"d or 9th, 2019.
Special Events
Beach +Kite Fest
Due to the forecasted impact of Potential TS 9 last week, Staff elected to err on the side of
caution and reschedule the event, for Saturday, September 281h at Cherie Down Park. Because
this year's event is shaping up to be bigger and better than ever,it was too good to let it be ruined
by a little rain!
Guests this year will enjoy the return of the kids' sand sculpture contest, paddle board +yoga
demonstrations, a meet+ greet opportunity with the City's Sustainability Team, a whole host of
fun family activities like giant Jenga, cornhole, Connect 4, and of course—free kites for the first
200 kids! In true Community fashion, proceeds from food and drinks will benefit Space Coast
Little League. But that's not all
In conjunction with the 2019 Beach + Kite Festival, a local young surfer will be hosting Snazzy
Jassy's Spongefest, the City's first all-ages, beginners welcome and family friendly soft board
surf competition. Just$25 to register, the main competition is broken down by age group and for
an additional fee, contestants can join the all-ages "Open Total Carnage" division.
For more information, log on to www.cilyofcqpecanaveral.org and check out our event calendar.
Friday Fest
Its been a rough summer with weather cancellations, so the September Friday Fest was a much
appreciated break from the rain. While the mural dedication had to be delayed due to the
interruption caused by Hurricane Dorian, it was a fun filled evening!
The mural dedication has been rescheduled for October and artist Anon will be in attendance for
a meet and greet with residents and fans. The dedication will take place at 7:00 p.m. in front of
the mural on Taylor Avenue.
As always,Friday Fest is a free, family friendly event and we hope to see all of you there! This
month's beer and wine sales benefit the City's youth cultural programs and volunteers are
needed to work the booth. If you would like to lend a hand,please contact Aaron Leyte at
a.leyteggityofegpecanveral.org or call the Leisure Services office at(321) 868-1226.
Food Truck Street Party @ City Hall
The rebranded and relocated quarterly Food Truck event saw marked success with the August
visit. Now, residents, staff and the event's coordinators are looking forward to another incredible
evening of games,music and food!
The next event is scheduled for
- Saturday,November 11th from 5:30 -
8:30 p.m. and will feature family
lip friendly activites like Giant Jenga,
Corn-hole, Connect-4 and, back by
popular demand, Community
Karaoke. Admission is free and
leashed dogs are welcome.
"Movie in the Park" Series Line-up
The fall "Movie in the Park" series is upon us! It kicks off in October with the brand new live
action movie,Aladdin (www.imdb.com/title/tt6l39732/); the fun continues in November with
one of the biggest films of 2019, The Lion King(=.imdb.com/title/tt6lO5098/); and closes it
out with the hilarious animated remake of The Grinch (www.imdb.com/title/tt2709692/). The
events takes place on the third Friday of the month and the October event will take place at
Canaveral City Park. Stay tuned, however,for the exciting possibility of a new location for the
November and December events!
24th Annual Reindeer Run 5K
Online registration has begun for the 2019 Reindeer Run! This year's race will take place on
Saturday,December 14th starting at Cheri Down Park. One hundred percent of the proceeds from
this race support our local PAL Program. This is the best run/walk event on the north beaches
and benefits a great cause and the first 600 registrants will receive a long sleeve tech shirt. Early
registration is only $25 through November 15th, so don't miss the huge savings! Runners may
still register the day of the event for $35. Visit the signup page today and start training!
Youth Programs
Youth Sports in the City
There is little better than team sports, when it comes to improving a child's physical and mental
health. The benefits derived from participating in organized athletics are countless, and many are
available within our 1.9 m2 City. The local organizations listed below make it both affordable
and convenient for busy families! Scholarships are available for those who qualify and both
organizations have parent networks to coordinate rides to and from the fields!
• Local Youth Baseball— Space Coast Little League: Starts as young as age 4.
• Local Youth Soccer— Cape Canaveral Soccer Club: Starts as young as age 3.
If team sports aren't your child's thing, the Nancy Hanson Recreation Complex offers several
other activities, including Karate,Aikido and Tennis. For information on these or any of our
other programs, check out the City's website and get your child involved. They will thank you
for it later!
Youth Center
Now that school is back in session, the Youth Center is offering a getaway from the daily stress
of school life, for children ages 10 to 15 years old. The Youth Center is open from 4:00 p.m. to
6:30 p.m. Monday through Thursday and from 3:00 p.m. to 6:30 p.m. on Fridays,with
homework help available for the first hour. There are video games,pool, foosball,ping-pong and
tables games available at no charge. Staff is background screened and finger printed to assure
safety.
Summer Camp
The Summer of Space has ended and campers are already back to school. The 2019 Cape
Canaveral Summer Camp remained at full capacity for the majority of the summer with a
maximum of 50 kids each week.
Throughout the summer, campers took trips
to the Cocoa Beach Aquatic Center, Cobb
Movie Theater, Shore Lanes in Merritt
Island, Cape Canaveral Public Library and
-- --= the Cape Canaveral Fire Department.
Campers also experienced special guest
presenters such as Astronaut Winston Scott,
BCSO's K9 unit, NASA's Launch Services
Program, University of Florida IFAS, as
well as a variety of performances and shows
hosted by the Cape Canaveral Public
Library.
Campers celebrated the #SummerofSpace and learned about a new planet each week; they also
completed a few community service projects throughout the summer, including a beach cleanup
and designing, creating and opening the sixth Little Free Library in the City!
During the final week of Summer Camp, campers played Scooter Ball at the recreation complex
and had a fun day of outdoor water games. The last day,the Summer Camp Extravaganza invited
all campers that had attended over the summer back to enjoy an afternoon of bounce houses, a
slip and slide and tons of outdoor games and activities.
Classes, Athletics and Wellness
Racquetball
After a few weeks of weather cancellations,racquetball ramped up with tough matches. Greg is
leading the pack with a perfect record, and working hard to maintain it as playoffs approach.
Kickball
Although tied for wins with Who's Sober, Graham's still leads the league on point differential.
This week's games saw Graham's defeating JTS by six runs; Who's Sober defeating GTR by
eight and the SOMB pulling the win from Reds by seven. This close score activity makes the
league even more exciting with the top two teams now tied for first.
Tennis
A new round of Monday night tennis will start next week. We are excited to welcome two new
players, Steve and Patty, who are new residents and look forward to a fun season. Due to the
many weather cancellations, Wednesday night tennis is finishing make-up matches. As of right
now,we have a four-way tie for first, so these leftover matches will play a huge role in the
playoffs. Thursday tennis is off to a great start, also with a four-way tie for first. It is not over
yet, but so far, all players have brought their"A" game.
Parks & Facilities
Leisure Services Maintenance Projects
Repair and preventative maintenance projects are never-ending in a humid and salty environment
like ours. Last month, Staff removed and replaced the rotted landscape bed timbers at the front of
the Nancy Hanson Recreation Complex. In the coming weeks, Staff will begin replacing the
timbers on the ADA ramp at Manatee Sanctuary Park, the wood on the observation deck at
Banana River Park and adding field conditioner to the Little League field at Canaveral City Park.
Wagner Park in the News!
Last week Spectrum News 13 featured Wagner Park, the City's new pocket park, highlighting its
storm water capture and detention abilities. You can find the news story here:
https://www.mynews 13.com/fl/orlando/news/2019/07/28/plants-at-cape-canaveral-park-
desi fined-to-reduce-runoff
Gardening in the City
On July 1, 2019 Florida's new bill, CS/SB 82: Vegetable Gardens, went into effect. The bill
prohibits:
"a county, municipality, or other political subdivision of the state from regulating
vegetable gardens on residential properties. Any local ordinance or regulation
regarding vegetable gardens on residential properties is void and unenforceable.
However, the bill does not preclude the adoption of a local ordinance or
regulations of a general nature that do not specifically regulate vegetable gardens,
including, but not limited to, regulations and ordinances relating to water use
during drought conditions,fertilizer use, or control of invasive species."
The bill also defines the term "vegetable garden" as a plot of ground where herbs, fruits, flowers,
or vegetables are cultivated for human consumption.
The City of Cape Canaveral supports this bill, as it allows residents to become more engaged in
the practice of urban agriculture, improves Community resiliency and falls in line with the City's
sustainability efforts. To optimize best practices and ensure safety while keeping sustainability a
priority,the City will be releasing a set of suggested guidelines within the next few weeks to
assist residents in their gardening
efforts. Such suggestions may include:
the recommendation of using eco-
friendly fertilizers as a reminder to
continue to adhere to the City and
County's fertilizer ordinances; efficient
watering habits; garden bed plans used ,.
at the City's Kairos Community Garden .
(see1p ans and line of sight
considerations foredestrian and
p -
vehicle traffic safety. 6 r \
Residents can find these guidelines on the City's website, within The Weekly Update and on all
official City social media platforms. Happy gardening!
City Installs Second Beach Box
Look out Washington Avenue—you've got a
new toy box! Come fill this cute Community
beach toy box with beach toys!
Cultural Programs
Community Garden Presents STEAM Opportunity
Last semester, Staff reached
out to Cape View - r
Elementary with a unique
community arts
z
opportunity—but not one for F @Y I d
the art classes. The project
invited science classes to
create designs to decorate jh
rain barrels for the
Y
community garden using
concepts they were learning about in class. The result was four incredible designs with an
underlying theme of sustainability: "Good Garden Bugs," "The Water Cycle," "Dune
Conservation" and "Sustainable Energy." These were turned into UV-resistant vinyl wraps and
applied to the 55-gallon barrels that were installed in the Community Garden last week. This was
the first coordinated STEAM activity between the City and Cape View Elementary, and given its
success, Staff is exploring more arts collaboration ideas for the coming school year.
Traffic Control Project Wraps Up!
#ThatsAWrap Finally! After several weeks of construction and weather delays, the traffic control
cabinet wrap project is complete! This was the first public art project for the 2019 Summer of
Space celebration and each design features images relating to the past,present or future of space
exploration here in Cape Canaveral. The artists that contributed to this project were both local
and out-of-state, ranging from elementary and high school students,to retired space center
employees—and in a way, it reflects how the Moon landing anniversary was not just a milestone
for Cape Canaveral, but for all of humanity.
So now, when you're waiting for the light at the intersections listed
below, there is a little reminder that you're lucky enough to live in
The Space Between Liftoff+ Landing!
SR AIA @:
Holman Road+ Center Street+Jackson Avenue+N. Atlantic
- Avenue +West Central Boulevard
North Atlantic Avenue @:
;; W. Central Boulevard+ Canaveral Beach Boulevard
2020 Student Art Show to Introduce STEAM Category
With the new school year already underway, it is time to roll out the plans for the next Student
Art Show! Although last year's show will be difficult to top, the City's Cultural Programs
Manager still has a few tricks up her sleeve to make this one even better!
Given the success of last semester's rain barrel project, and the overwhelming curriculum
focuses on science, technology, engineering,ARTS and mathematics,it is time to introduce
cross-collaborative art projects into the show. This will allow students to incorporate concepts
they are learning in other areas of their coursework and highlight the integral connections
between creativity and scientific applications.
Due to conflicts with other local art shows, Cape Canaveral's 2020 event will take place the first
week of April at the Cape Canaveral Public Library. Weather permitting, awards will be
presented on the main stage at Friday Fest at 7:00 p.m. on April 3, 2020.
Campers Dedicate Little Free Library 46
As part of the Summer of Space, children enrolled
in the City's Summer Camp program were on
hand to dedicate Little Free Library (LFL) they
helped decorate. The sixth LFL location in the
City, this Summer of Space-themed Little Free =tea
Library is located near the flagpole in the City
Hall Plaza. In the last three years, Cape Canaveral
has become a Champion for the Little Free �(
Library program, which serves to promote literacy and public accessibility to books and cultural
enrichment. With more Little Free Libraries and Little Free Pantries per square mile than any
other Community in Brevard, the City of Cape Canaveral continue to reinforce its commitment
to supporting accessibility to arts for all.
Memories to Last a Lifetime: Host Families Reflect on the IYEP Visit
Six local families made memories that will span the globe and last a lifetime,by welcoming
student visitors from Kimotsuki,Japan into their homes. For the second year in a row, Kimotsuki
chose the City of Cape Canaveral to be the host community as part of the International Youth
Exchange Program (IYEP), aimed at promoting global diffusion and facilitating English literacy
for participating students. The benefits of immersive cultural enrichment programs like this go
both ways, and have lasting positive impacts on both the visitors and the communities they visit.
For several of our host families,
nn this is their second year
welcoming IYEP student guests
Atl and so far the only negative
feedback Staff has received is that
their visit is too short. These six-
day visits are action-packed and
h trip's
t e t p s have
activities and excursions planned
for the students almost every day
of their stay. In their few moments of downtime,host families get to enjoy showing off the best
our community has to offer from enjoying local pastimes to seeing the Florida sights!
With another positive experience in the books, Staff is already looking forward to next year and
hopes that more local families will consider taking part!
Library News
Libraries: Not Just for Book Worms Anymore
As Cape Canaveral Library Director Lisa Olzewski explained at the last Library Board meeting,
many libraries across the country are shifting their focus from books and traditional media
services to Community Enrichment Programs. This trend is evident right here in Cape Canaveral
where library visitors can take part in craft activities, enjoy local history presentations or bring
their children in for a creativity building Lego session. Libraries are no longer just dusty book
repositories; they are places for Communities to come together.
Wellness programs are also part of this trend. One of the newest ones to come to the Cape
Canaveral Public Library (CCPL)is the Senior Fitness Class. Each Wednesday, fitness instructor
Polly Helm leads a 2-hour low-impact workout designed to help increase stamina, strength and
balance. But that's not all—on the third Tuesday of each month, the Visiting Nurses Association
hosts a free Blood Pressure Clinic where visitors can receive a free blood pressure check and get
important resources on heart health and blood pressure management. CCPL is also a destination
for One Blood's Big Red Bus, which was just in town last week. Their next visit will be October
18th so stay tuned for details!
If you haven't checked out the CCPL Calendar or visited recently—you're overdue! Stop in this
week!
Book Clubs: Building Language,Building Community
The idea of a book club is nothing new. It is a fantastic social activity for those who enjoy
reading but the benefits of book clubs actually transcend those of just a casual past time. In
reality, they can be tools that help build understanding and bring communities together by taking
readers beyond their usual literary comfort zones and into new and enlightening cultural
landscapes. They allow readers to come together and share what are sometimes widely differing
interpretations of the same text, exposing the many ways people perceive personalities, tone,
events and emotions.
If you have never thought of book clubs like this, see for yourself! The Cape Canaveral Public
Library selects a different book each month and all are welcome to join the club! Contact
Danelle at(321) 868-1101 for more information.
Library Programs Signal the First Hint of Fall
If you step outside, it certainly doesn't feel like fall, but one glance at the Cape Canaveral LibEM
Calendar will tell you that the seasons are about to change. September will see the return of
Linda's Adult Watercolor Classes and Children's Story Time on Wednesdays and Thursdays.
Also, the Children's Lego Challenge activity has moved to Friday afternoons to accommodate
back-to-school schedules.
Do not forget to drop by the Circulation Desk and pick-up a copy of September's Book Club
selection, Before We Were Yours by Lisa Wingate and stay tuned for more fall program
announcements!
Other News
New Recreation Software Coming to Leisure Services
In an effort to improve customer experience and internal efficiencies, the City's Leisure Services
Department will be utilizing RecDesk for internal and external transactions for the upcoming
fiscal year. The new software will allow for online registrations for rentals, events and programs;
general program management, to include facility scheduling and instructor billing; membership
and league management; point-of-sale transactions, and email marketing.
The full suite of products included in a very low flat fee. The company touts how they are the
only recreation software provider that is all-inclusive with no additional cost for extra modules or
updates as their system grows. The system will not go live until October 1, 2019 as Staff works
to not only ensure a smooth kick-off but integration with the City's new BS&A software and
Point&Pay credit card processing system. Cape Canaveral is catching up with the world of
technology!
Cape View Elementary Playground Update
Crews completed the installation of the much-anticipated new playground at Cape View
Elementary just in time for the new school year! What a wonderful way to kick off a new
semester!
CITY OF CAPE CANAVERAL
APPLICATION FOR APPOINTMENT TO CITY ADVISORY BOARD OR COMMITTEE
Pursuant to Section 2-171,Cape Canaveral Code
City Code requires prospective and existing board members to fill out an application. City. Code also
prohibits a person from serving on a City Board or Committee if that person has been convicted of a
felony, unless their civil rights have been restored.
Please complete the following in the space provided:
A. GENERAL-
1.
ENERAL1. Applicant Name: T/7f V,,l
2. Home Address:
G����d�i/1f1���l�
3. Home and Cellular elep one: /��✓—(o/3—3/
4. Occupation: T/12r� /1zu�2T ��oi�T�l2
5.- Business Telephone: /v
6. Business Address:
7. E-Mail: A 74
B. ELIGIBILITY
The information provided in this section is for purposes of determining,whether you are eligible,to serve
on a City advisory board or committee.
1. Are you duly registered to vote in Brevard County? (Y)_Z(N)
2. Have you been a resident of the City of Cape
Canaveral for 12 months or longer? (Y) (N)
'2
3a. Are you a Business owner: N
Y � ( )
3b. If yes to 3a, please list the name:
4a Have you ever been convicted or found guilty, regardless
of adjudication, or a felony in any jurisdiction?Any plea
of nolo contendere(no contest) shall be considered a
conviction for purposes of this question: (Y) (N) f/
4b. If yes to 4a, have your civil rights been restored? (Y) (N)
5a. Do you presently serve on any other City of Cape
Canaveral advisory board or committee?
(Y-) (N)
5b. If yes to 5a, please list each:
Page 1 of 3
6. City ordinance requires that all persons applying for a
City advisory board or committee must voluntarily consent
to a standard criminal background check before being
appointed to a board or committee. Do you voluntarily initials
consent to having a standard background check
performed on.-you by the City of Cape Canaveral? (Y)_LZ(N)
7a. Are you related to a City of Cape Canaveral Council
member by blood, adoption, or marriage? (Y) . (N)
7b. If yes to 7a, please provide name(s) of person(s)and relationship to you:
C. INTERESTSIEXPERIENCE
1. Briefly state your interest in serving on a City advisory board or committee-
7i �eco � vr� i:�Jt��/.vim '' s✓'I ��� ��� +.
2. In numerical sequence (1 = most interested), please rank which advisory board or committee
on which you wish to serve:
a. Board of Adjustment*
b. Business and Economic Development Board
C. Code Enforcement Board*
d. Community Appearance Board
e. Construction Board of Adjustment and Appeals*
f. Culture and Leisure Services Board
g. Library Board
h. Planning and Zoning Board*
i. Other:
*Members of these boards are required to complete and file with the supervisor of Elections a Financial
Disclosure Form upon appointment to said board and prior to July 1 of each year following the initial
appointment while still a member of said board.
3. Brie y state any prior experiences in serving on any governmental board or committee:
A
4. Please list any specialized skills and training (e.g., architect, engineer, general contractor, etc.)
that you feel help to quaallify you for membership on the desired board or committee.
D. STATE REPORTING REQUIREMENTS
Section 760.80, Florida Statutes, requires that the City annually submit a report to the Secretary of State
disclosing race, gender, and physical disabilities of board and committee members. Please check the
appropriate boxes:
Page 2 of 3
RACE GENDER
African-American Male
Asian-American Female
Hispanic-American Not Known
Native-American
Caucasian DISABILITY
Not Known Physically disabled
YOU HEREBY REPRESENT TO THE CITY OF CAPE CANAVERAL, UNDER PENALTY OF
PERJURY, THAT THE INFORMATION PROVIDED HEREIN IS TRUE AND ACCURATE TO THE
BEST OF YOUR KNOWLEDGE,AND THE CITY OF CAPE CANAVERAL HAS THE RIGHT TO RELY
ON THAT INFORMATION.
YOU HEREBY ACKNOWLEDGE THE EXISTENCE OF THE CODE OF ETHICS FOR PUBLIC
OFFICERS [SECTIONS 112.311-326, FLORIDA STATUTES] AND THE FLORIDA "SUNSHINE
LAW" [SECTION 286.011, FLORIDA STATUTES], WHICH MAY PERTAIN TO YOU IF YOU ARE
APPOINTED TO A CITY ADVISORY BOARD OR COMMITTEE, AND IF APPOINTED, IT IS YOUR
SOLE OBLIGATION AND DUTY TO COMPLY WITH SUCH LAWS.
PLEASE NOTE:
• Appointment to any City board is subject to City Council approval following a brief interview
before the City Council at a regularly scheduled meeting.
• Your application will remain effective for one year from date of completion.
If you should have any questions regarding the completion of this application, please contact
the City Clerk's Oe at(321) 868-1220 ext. 207.
/t-
Signatur Date:
Gc/
Please re urn to, City of Cape Canaveral
Office of the City Clerk
100 Polk Avenue
Cape Canaveral Florida 32920
For Office Use Only:
Date application received:
Date Appointed:
Appointed by:
Board Appointed to:
Term Expires:
Page 3 of 3
CITY OF CAPE CANAVERAL
APPLICATION FOR APPOINTMENT TO CITY ADVISORY BOARD OR COMMITTEE
Pursuant to Section 2-171, Cape Canaveral Code
City Code requires prospective and existing board members to fill out an application. City Code also
prohibits a person from serving on a City Board or Committee if that person has been convicted of a
felony, unless their civil rights have been restored.
Please complete the following in the space provided:
A. GENERAL
1. Applicant Name: L r1-1 I e
2. Home Address: 35q A ✓E
3. Home and Cellular Telephone: Molt Clt 360
4. Occupation: PAs-ro2
5. Business Telephone: 3Z 1 978 - S 77 2-
6.
6. Business Address: 57_7 �gAQN s ��✓l� 12oLKs
t,-b&9 rt- 3Zci "S
7. E-Mail: � �� 5-717PP�,Mc., C e,=-7
B. ELIGIBILITY
The information provided in this section is for purposes of determining whether you are eligible to serve
on a City advisory board or committee.
1. Are you duly registered to vote in Brevard County? (Y) ✓� (N)
2_ Have you been a resident of the City of Cape f
Canaveral for 12 months or longer? (Y) ✓ (N)
3a. Are you a Business owner: (Y) (N) ✓
3b. If yes to 3a, please list the name: fA
4a. Have you ever been convicted or found guilty, regardless
of adjudication, or a felony in any jurisdiction?Any plea
of nolo contendere (no contest) shall be considered a /
conviction for purposes of this question. (Y) (N) ✓
4b. If yes to 4a, have your civil rights been restored? (Y) (N)
5a. Do you presently serve on any other City of Cape
Canaveral advisory board or committee? (Y) (N) ✓
5b. If yes to 5a, please list each: �lL
Page 1 of 3
6. City ordinance requires that all persons applying for a
City advisory board or committee must voluntarily consent
to a standard criminal background check before being
appointed to a board or committee. Do you voluntarily initials
consent to having a standard background check /
performed on you by the City of Cape Canaveral? (Y) ✓ (N)
7a. Are you related to a City of Cape Canaveral Council
member by blood, adoption, or marriage? (Y) (N)
7b. If yes to 7a, please provide name(s) of person(s) and relationship to you: �A
C. INTERESTS/EXPERIENCE
1. Briefly state your interest in serving on a City advisory board or committee:
NAN, ry 64R✓E Oche c art' /a,✓r) 9&,^IL 4 PCPSPr�-r/ ' '
2. In numerical sequence (1 = most interested), please rank which advisory board or committee
on which you wish to serve:
a. Board of Adjustment*
b. Z Business and Economic Development Board
C. Code Enforcement Board*
d. _ 3 Community Appearance Board
e. Construction Board of Adjustment and Appeals*
f. 1 Culture and Leisure Services Board
g. Library Board
h. Planning and Zoning Board*
i. Other:
*Members of these boards are required to complete and file with the supervisor of Elections a Financial
Disclosure Form upon appointment to said board and prior to July 1 of each year following the initial
appointment while still a member of said board.
3. Briefly state any prior experiences in serving on any governmental board or committee:
AIoNE
4. Please list any specialized skills and training (e.g., architect, engineer, general contractor, etc.)
that you feel help to qualify you for membership on the desired board or committee.
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D. STATE REPORTING REQUIREMENTS
Section 760.80, Florida Statutes, requires that the City annually submit a report to the Secretary of State
disclosing race, gender, and physical disabilities of board and committee members. Please check the
appropriate boxes:
Page 2 of 3
RACE GENDER
African-American L Male
Asian-American Female
Hispanic-American Not Known
Native-American
Caucasian DISABILITY
Not Known Physically disabled
YOU HEREBY REPRESENT TO THE CITY OF CAPE CANAVERAL, UNDER PENALTY OF
PERJURY, THAT THE INFORMATION PROVIDED HEREIN IS TRUE AND ACCURATE TO THE
BEST OF YOUR KNOWLEDGE,AND THE CITY OF CAPE CANAVERAL HAS THE RIGHT TO RELY
ON THAT INFORMATION.
YOU HEREBY ACKNOWLEDGE THE EXISTENCE OF THE CODE OF ETHICS FOR PUBLIC
OFFICERS [SECTIONS 112.311-326, FLORIDA STATUTES] AND THE FLORIDA "SUNSHINE
LAW" [SECTION 286.011, FLORIDA STATUTES], WHICH MAY PERTAIN TO YOU IF YOU ARE
APPOINTED TO A CITY ADVISORY BOARD OR COMMITTEE, AND IF APPOINTED, IT IS YOUR
SOLE OBLIGATION AND DUTY TO COMPLY WITH SUCH LAWS.
PLEASE NOTE:
• Appointment to any City board is subject to City Council approval following a brief interview
before the City Council at a regularly scheduled meeting.
• Your application will remain effective for one year from date of completion.
• If you should have any questions regarding the completion of this application, please contact
the City Clerk's Office at (321) 868-1220 ext. 221.
Signature: Date: 71Z-7 / I
Please return to: City of Cape Canaveral
Office of the City Clerk
105 Polk Avenue
Cape Canaveral Florida 32920
For Office Use Only:
Date application received:
Date Appointed:
Appointed by:
Board Appointed to:
Term Expires:
Page 3of3
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