HomeMy WebLinkAboutRecommendation to City Council - Rosalie WolfMEMORANDUM
Date: June 16, 2009
To: Bennett Boucher, City Manager
Susan Stills, City Clerk
From: Susan Chapman, Secretary
Community Appearance Board
Re: Potential Board Member - Rosalie Wolf
On June 15, 2009, Citizen Rosalie Wolf, a potential Board member,
was interviewed by the Community Appearance Board= Following the
interview and discussion, by unanimous vote, the Board members
recommended that the City Council appoint Rosalie Wolf as a new
member to the Board.
Please schedule this recommendation on an upcoming City Council
Agenda. Also, please notify Mrs. Wolf of the date she will be
interviewed by the City Council.
Thank you.
CITY OF CAPE CANAVERAL
APPLICATION FOR APPOINTMENT TO CITY ADVISORY BOARD
Pursuant to Section 2=171, Cape Canaveral Code
1
JAN 2 9 2009
COMMITTEE
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. Applicata Name:
2. Home Address: ?J G�j X11 CC.J�0
3. Home Telephone:
4. Occupation: ��-� t t'tt�J
5. Business Telephone: R
6. Business Address: i1
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.
c-ri I
r. Are you duly fC�EateI vote es _inrovai �uuec Y s
2. Have you been a resident of the City of Gape
Canaveral for 12 months or longer?
32. Have you ever been convicted or found guilty, regardless
of adjudication, of a felony in any jurisdiction? Any plea
of nolo contendere (no contest) shall be considered a
conviction for purposes of this question.
3b. If yes to 3a, have your civil rights been restored?
4a. Do you presently serve on any other City of Cape
Canaveral advisory board or committee?
4b. If yes to 4a, please list each:
t J N) -
(Y)
(N)
(Y) (N) -XL
(Y)(N)
Y
5. 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
tllr
appointed to a board or committee. Do you voluntarily
initials
consent to having a standard background check
by City Cape Canaveral?
(1')_X\
performed on you the of
(N)
6a. Are you related to a City of Cape Canaveral Council
member by blood, adoption or marriage?
(Y)(N)_)<
6b. If yes to 6a, please provide name(s) of person(s) and relationship to you:
C. INTERESTS/EXPER[ENCE
1. Briefly state your interest in serving on a City adMisory board or committee:
-H-or 13 C, ' n' Cit*\d ° c.i. a..1\ V— (�
2. Briefly state any prior experiences in serving on any governmental board or committee:
tV ;n e,
3. 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: tt t
i �-„ ri �,\ i n ti t' - ! ve- R�CLI t or 4C� y; 1�.:_ . ( 4 ��t� �� i n
4. In numerical sequence (1 = most interested), please rank which advisory board or
committee on which you wish to serve:
a. Beautification Board
b. Board of Adjustment*
C, Dusi ess a, SV btA1t4.S[ 46 l,JC.7GfiilJ[ S ICI [t C7tJG1 u
d. Code Enforcement Board*
e. Community Appearance Board* EuSr t t i t F'
f. le> Construction Board of Adjustment and Appeals* ---"� 1
g. Library Board S AC C6-
tt. Planning and Zoning Board*
i. Recreation Board
�. Other C e-ti1C�9-
'Members of these boards are required to complete and file with the Supervisor of Elections a
Fir7ancial Disclosure Farm upon appointment to said board and prior to Jufy 1 of each year
following the initial appointment while still a member of said board,
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:
RACE
GENDER
African-American
Male
Asian -American
_ X
Female
Hispanic -American
Not Known
Native American
x Caucasian
DISABILITY
Not Known
Physically disabled
YOU HEREBY REPRESENT TO THE CITY OF CAPE CANAVERAL. ; UNDER PENAL? -IES 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;
• Initial 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 the date of completion.
• If you should have any questions regarding the completion of this application, please
contact the City Clerk's Office at j3`1 j 868-121221.
Signature: -"i
Lute: I - Z RC
Please return to: City of Cape Canaveral
Office of the City Clerk
105 Polk Avenue
Cape Canaveral, Florida 32920