HomeMy WebLinkAboutRenshaw Application 12-7-87Ti i
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CITY OF CAPE CANAVE
QUALIFICATIONS FOR SERVING ON CITY BOARDS
1. Name -A eiZ z y S lk)
2. Home Address:
Home Telephone: -7 9, Z
3. Business: c,_ a I 0/V4 (,,BUS ines s Telephone: /C Cf / a 0 0
4. Office Address: Scpu 0 A ___
5. Brief Resume of Education and Experience:
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eo G (Th N
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6. Are you a registered Voter? Yes LV
7. Resident of City for 12 months or longer? Yes
8. Do you hold a public office? Yes No
9. Are you employed by the City? Yes No
10. At the present time, do you serve on a City Board? Yes No
11. Name of City Board You Are Interested In Serving On: (Specify Preference)
(1st, 3rd
Beautification Board
Board of Adjustment*
Code Enforcement Board*
Library Board
1 Planning and Zoning Board*
2, Recreation Board
12. Qualifications to serve on this Board:
No
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13. Would you consider serving on another Board other than the one you
selec bove?
Signature:
Yes
No
Date
NOTE: (1)--Applica on effective for one yer from date of completiork.
(2) If you ha any questions on the above, please call the
office of City Clerk, Telephone 783-1100
*Financial Disclosure Form must be completed each year, prior to July 15,
by members of these Boards.
FOR OFFICE USE ONLY:
Appointed to Board on
Term to Expire
(Date)
(Date)
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