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10-05-2011 CITY OF EDGEWATER SCHOOL SCHOLARSHIP COMMITTEE REGULAR MEETING Wednesday, October 5, 2011 5:00 P.M. Council Chambers 104 N. Riverside Drive AGENDA 1. CALL TO ORDER 2. ROLL CALL 3. APPROVAL OF MINUTES — None at this time 4. OLD BUSINESS a. Marketing update. 5. NEW BUSINESS a. Discussion of appointment to fulfill the remaining term of Anne McCulloch, who resigned. 6. OTHER BUSINESS — None at this time 9. ADJOURN Pursuant to Chapter 286, F.S., if an individual decides to appeal any decision made with respect to any matter considered at a meeting or hearing, that individual will need a record of the proceedings and will need to ensure that a verbatim record of the proceedings is made. The City does not prepare or provide such record. In accordance with the Americans with Disabilities Act, persons needing assistance to participate in any of these proceedings should contact City Clerk Bonnie Wenzel, 104 N. Riverside Drive, Edgewater, Florida, telephone number 386- 424 -2400 x 1101, 5 days prior to the meeting date. If you are hearing or voice impaired, contact the relay operator at 1- 800 -955 -8771. CITY OF EDGEWATER SCHOOL SCHOLARSHIP COMMITTEE REGULAR MEETING Wednesday, October 5, 2011 5:00 P.M. Council Chambers 104 N. Riverside Drive AGENDA 1. CALL TO ORDER 2. ROLL CALL 3. APPROVAL OF MINUTES — None at this time 4. OLD BUSINESS a. Marketing update. 5. NEW BUSINESS a. Discussion of appointment to fulfill the remaining term of Anne McCulloch, who resigned. 6. OTHER BUSINESS — None at this time 9. ADJOURN Pursuant to Chapter 286, F.S., if an individual decides to appeal any decision made with respect to any matter considered at a meeting or hearing, that individual will need a record of the proceedings and will need to ensure that a verbatim record of the proceedings is made. The City does not prepare or provide such record. In accordance with the Americans with Disabilities Act, persons needing assistance to participate in any of these proceedings should contact City Clerk Bonnie Wenzel, 104 N. Riverside Drive, Edgewater, Florida, telephone number 386- 424 -2400 x 1101, 5 days prior to the meeting date. If you are hearing or voice impaired, contact the relay operator at 1- 800 -955 -8771. } �DGT WA I RI ADVISORY BOARD — VOLUNTEER APPLICATION Thank you for your interest in serving the City of Edgewater. Your completion of this application is necessary so that the members of the City Council can thoroughly review each application as part of their consideration for the appointment. Please choose the Board(s) for which you wish to apply. If applying for more than one Board, you must number in order of your preference. ANIMAL CONTROL CITIZEN CODE ENFORCEMENT* LIBRARY POLICE PENSION* CONSTRUCTION REGULATION* RECREATION & CULTURAL SERVICES ECONOMIC DEVELOPMENT PLANNING & ZONING* FIREFIGHTERS PENSION* VETERANS PARK AVD. COMMITTEE Members of the Boards with an asterisk ( *) are required to file a Financial Disclosure form within 30 days of appointment. PERSONAL INFORMATION Name WO'Ld Ley - PRyEm. Address f 00 1 (Z,r.ET ECIG e wATF . 32)3 Horne Phone 38" 4 a.7- k, 3 4 3 Business /Cell Phone 3% 08e? Occupation V i �,e� E (L aaiescTo(z Are you a resident of Edgewater . how long 3OyaS Is your principal place of employment in Edgewater /ES At the present time, do you serve on any other City Boards or Commissions NO if yes, please list each Have you ever served on any Boards, agencies or committees ytS if yes, please list each e«lTIzAcTo AA. soRy RO At2A. NEw S Wn'{Rni A ES eAc \,� REFERENCES — Please list three business and /or personal 6e, 3 *VaR,rhE rn A; ov E Name, address and phone ,16E F (A>RrN�g- TN 'Ai A ( ASS Nmoe, address a d phone J '( V)FAc F 1 tcl't; Name, address and phone 1 1 Page EDUCATION High School NEW S my YLN A SAC V k .,\A Sc \- o) College SL'1M: nerd) - r- Co\lr, to - LAu E-N '�oYlc��cv,F Degree(s) A :v -0k N—t 1 EN( NE -111-t 0 .P*1 i" , WORK EXPERIENCE O y)2. S - &) i \ t' `2_. CO IVi (2?C \ O V.- INTEREST /ACTIVITIES 4!)--F1 0 ■\\ — ' COMMUNITY INVOLVEMENT rONTI2 N e10X A It ,; s o YIN 1DhRA_ o 4 MEL SM\y12 /4 A PAC V\ . WHY (.0 DO YOU DEESIRE TO SERVE ON THIS // THESE BOARD(S)? ICA E Lk ► Nl i= yt- CO nm v y o N ■ 1 ' ( TN oc9 l V5141 ENI (_ EXPERIENCE/QUALIFICATIONS RELATED TO BOARD(S) APPLYING FOR w��R l V /t ML) (s 01(4-\( u O 412. d 0 - F El �.) � my9,ptA 'r/d t"1 A resume or separate sheet with additional information may be included with your application. I understand the responsibilities associated with being a board member, and I have adequate time to serve if appointed. 1/ r Applicant Sigi .tureI Date Please return this application to Bonnie Wenzel, City Clerk, City of Edgewater, P.O. Box 100, Edgewater FL 32132 or drop off in the City Clerk's Office, 104 N. Riverside Drive, Edgewater FL 32132. If you have any questions please call 386 - 424 -2400. OFFICE USE ONLY Date Application Received Date Appointed to Board Board Appointed to Date Resigned from Board 2(Page CITY OF EDGEWATER RECEIVED} F. 'ti f C 4 .•"f } t C:. TY CLERK ADVISORY BOARD — VOLUNTEER APPLICATION Thank you for your interest in serving the City of Edgewater. Your completion of this application is necessary so that the members of the City Council can thoroughly review each application as part of their consideration for the appointment. Please choose the Board(s) for which you wish to apply. If applying for more than one Board, you must number in order of your preference. ANIMAL CONTROL CITIZEN CODE ENFORCEMENT* LIBRARY POLICE PENSION* CONSTRUCTION REGULATION* RECREATION & CULTURAL SERVICES ECONOMIC DEVELOPMENT 0 PLANNING & ZONING* FIREFIGHTERS PENSION* VETERANS PARK AVD. COMMITTEE Members of the Boards with an asterisk ( *) are required to file a Financial Disclosure form within 30 days of appointment. PERSONAL INFORMATION Name Elliott N. Hagood Address 2025 Orange Tree Dr Home Phone 386 - 426 -0847 Business /Cell Phone 386.690 -6546 Occupation Real Estate Broker Are you a resident of Edgewater YES how long f year Is your principal place of employment in Edgewater yes At the present time, do you serve on any other City Boards or Commissions no if yes, please list each Have you ever served on any Boards, agencies or committees yes if yes, please list each New Beach Board of REALTORS Legislative candidate screening committee REFERENCES — Please list three business and /or personal Mr. James Vandergrifft 386 424 -4750 Confidential address provided upon request only Name, address and phone Mr. George Beazley, Esq. 386 690 -8709 Confidential address provided upon request only Name, address and phone Mr. John E. Hagood 386 427 -0381 Confidential address provided upon request only Name, address and phone 11 A • EDUCATION High School New Smyma Beath High School 96 College University of Central Florida College of Business Degree(s) B.S.B.A. Management WORK EXPERIENCE Real Estate Sales, Leasing, Previously Licensed Mortgage Broker Boston Whaler Boat Manufacturing, Food Service, Satellite TV Sales, service & Installations Technician INTEREST /ACTIVITIES Fishing, Golf, Surfing COMMUNITY INVOLVEMENT desire for public service, to be continued... WHY DO YOU DESIRE TO SERVE ON THIS1THESE BOARD(S)? To improve our current and future quality of life in the city of Edgewater. EXPERIENCE /QUALIFICATIONS RELATED TO BOARD(S) APPLYING FOR My educational and professional experience have provided unique insight to all lifestyles present in our community, with this I am able to make informed decisions and serve the general public to improve our community's profile amongst others. A resume or separate sheet with additional information may be included with your application. I understand the responsibilities associated with being a board member, and I have adequate time to serve if appointed. .27 73/ // 16f10 App 'cant Signature Date Please return this application to Bonnie Wenzel, City Clerk, City of Edgewater, P.O. Box 100, Edgewater FL 32132 or drop off in the City Clerk's Office, 104 N. Riverside Drive, Edgewater FL 32132. If you have any questions please call 386 - 424 -2400. OFFICE USE ONLY Date Application Received Date Appointed to Board Board Appointed to Date Resigned from Board 2 ) ELLIOTT HAGOOD 621 S PINE ST. • NEW SMYRNA BEACH, FL 32169 PHONE (386) 690 -6546, 386 - 426 -0847 • E -MAIL SUMMARY OF QUALIFICATIONS • Real Estate (Licensed); Broker • Manager with education & experience in planning, operations and management, staff supervision, budgeting, start-ups and managing highly diverse projects. • An ability & reputation for: o Excellence in professional consultative services and customer relations. o Coordination of work of internal and external management and project teams as well as supervision and development of new systems and processes. o Strong interpersonal skills. o Working in fast- paced, relatively unstructured environments. o Internet and related technologies Various computer skills (MS Word, Excel, Access, PowerPoint ect. o Quickly understand and adapt to new technologies. o Knowledge of many aspects of project, facility management and operations. • Potential for: strategic planning, operations, facility management and project management, with special interests to develop strategies and managing operations to increase efficiency. An all- around Results oriented professional with a reputation as a conscientious manager who provides excellence in service and customer relations. EDUCATION 2004 University of Central Florida, Orlando, Fl ■ Management Degree B.S.B.A. WORK EXPERIENCE 2004- Present Licensed Real Estate Sales: Realtor Formerly Associate Experience at Waverly Property Group, ERA Select Intl. & OceanBreeze Properties Currently - Broker Home & Family Real Estate & Property Management LLC New Smyrna Beach, FL Duties: • Showcased property to potential clientele; provided comparable market analysis to customers; utilized online MLS real estate services; preparation of sales contracts; collaboration with various industry professionals; familiarization with appraising real property; interpreting inspection reports, comparative market analysis, legal documents, zoning maps, construction plans, population and land sales projection reports, and title abstracts; marketing; participation in open market activities, attended numerous closings, and otherwise aided in the transfer of real property. Extensive marketing and social network development. — 2 — February 23, 2011 2006 — 2/2007 Flagship Mortgage Banc, Inc. Daytona Beach, FL Loan Officer (Licensed Mortgage Broker) • Reference Contact Monique Hilton 386- 299 -3712 Duties: • Responsible for soliciting residential mortgages from various sources including realtors, builders, financial professional's, past customers and other nontraditional sources; produces high quality loans which meet applicable program guidelines while providing excellent customer service. Extensive marketing and social network development. Flagship Mortgage Banc, Inc is a subsidiary of Olde Cypress Community Bank. 2001 — 2005 Mastec Advanced Technologies DIRECT TV Orlando, FL Installation & Service Technician • Reference Contact Richard Jones (386) - 689 - 6481 Duties: • Installation, as well as testing and repair of Direct TV satellite for commercial customers, residential customers, and retail outlets by performing the following duties: Using problem - solving and technical skills to install satellite dishes and related equipment, Reviewing job site and communicating with customers to review the installation and operation process, Troubleshooting, providing customer education and managing the administrative processes including van inventory and appropriate documentation. Ensuring that the highest quality of service to promote superior customer satisfaction & Adhering to safety guidelines and requirements. REFERENCES Personal References Mr. George Beazley, Esq. 386 690 - 6709 Mr. James Vandergrifft. 386 424 - 4750 CONTACT INFORMATION: Elliott Hagood 621 5. Pine Street, New Smyrna Beach, Fl 386 690 -6546 APPLICATION FOR APPOINTMENT TO CITY BOARDS AND COMMITTEES Name SCo ,4/0,A Address 363c Ji /Vice P4 /•M .D? Home Phone 386 - Yfl 2 -73 S-r Business Phone Occupation ,fer•'QtI 2c� 5 47C Ce .% Are you a registered voter? f Voting District Are you a resident of Edgewater? yes How long? % /"A/71 S Is your principle place of employment in Edgewater? No If yes, how long / Briefly state your interest in serving on a City board or committee: % i •"9 fuI& iim b e/C( 6., f�.,,t,I4,./ mee 4 , iv f.ut !?gC'f 91.) 71e Cvey.w✓Yd. State your experience /qualifications .2 S? /ewe./ o ,' 74 L %d 6 gs 4 #4r1.(F9 c / f%t 4 xH r.rat o,') ' -' -mss •^�v Al, ,V, Are you employed by the City? /AP Do you hold public office / 4)0 At the present time, do you serve on any other Boards or committees? Nd If so, list each: /1///9 Have you served on any boards or committees? /Yo If so, list each: kJ/I/ BOARD AND COMMITTEE MEMBERS MAY BE REQUIRED TO FILE WITH THE STATE, FINANCIAL DISCLOSURE FORMS EACH YEAR PLEASE INDICATE THE BOARDS OR COMMITTEES YOU WOULD LIKE TO SERVE ON AND RANK THEM ACCORDING TO CHOICE BY NUMBER ANIMAL CONTROL BOARD GENERAL EMPLOYEES PENSION BOARD CITIZEN CODE ENFORCEMENT BOARD LIBRARY BOARD CONSTRUCTION REGULATION BOARD RECREATION & CULTURAL SERVICES ECONOMIC DEVELOPMENT BOARD PLANNING & ZONING BOARD X FIREFIGHTERS PENSION BOARD POLICE PENSION BOARD VETERANS PARK AVD. COMMITTEE Signature. N �" - Date 7 / 7 � r 1 OFFICE USE ONLY CITY OF EDGEWATER Board RECEIVED Date of appointment Term JUL 06 a I CITY CLERK CITY OF EDGEWATER , RECEIVED DGLWATti rOOYATERIF OGT 2 0 2010 ADVISORY BOARD — VOLUNTEER APPLICATION CITYCLERK Thank you for your interest in serving the City of Edgewater. Your completion of this application is necessary so that the members of the City Council can thoroughly review each application as part of their consideration for the appointment. Please choose the Board(s) for which you wish to apply. If applying for more than one Board, you must number in order of your preference. ANIMAL CONTROL CITIZEN CODE ENFORCEMENT* V LIBRARY POLICE PENSION* CONSTRUCTION REGULATION* RECREATION & CULTURAL SERVICES ECONOMIC DEVELOPMENT PLANNING & ZONING* FIREFIGHTERS PENSION* VETERANS PARK AVD. COMMITTEE Members of the Boards with an asterisk ( *) are required to file a Financial Disclosure form within 30 days of appointment. PERSONAL INFORMATION Name Avn L- Address 3 3 03 lC cycd 1 'a m Cr. E we FL 32141 Home Phone 3 13-o+ Business /Cell Phone #i9 66- / Occupation TYa . f1 .4, Are you a resident of Edgewater y ES how long 1 /ear Is your principal place of employment in Edgewater At the present time, do you serve on any other City Boards or Commissions Ak. if yes, please list each Hive yqu evej sere,gd on any Boards, a encies or committees 1QS if yes, please list each / ACei trliC C�vmm' Q 4A Exam Loma // , U 1 i ✓e : if' N y ettoi REFERENCES — Please list three business and /or personal 8% it TAO —On . 330y' / o c y d . ( n Pain Dr . 5 4 a r - L 3 2 I I t 1 ) 2 6 5 ? ) Name ado res and phone '., • , I suaL. , � 2,3 4 C ° O0 ,- 76 - 38 • Name, adore s and phone ^ - - � /2 , Q / 20 Qi � / se i t l� F32/32 < 48 6 Na e, address and phone 1 1 Pa • EDUCATION High School College Degree(s) 41 of S ) lit,rl l V"e-- O S (7 cle A izaa.QQ, WORK EXPERIENCE A/ PC IA ' I J , t ' AccI 1 n T , • J!/z.?l ,- c� A 4 I 41 • !II &/ P 4,111,s 1 INTEREST /ACTIVITIES ki tt,cd', „ rt COMMUNITY INVOLVEMENT , if ,, , old ,e WHY DO YOU DESIRE TO SERVE ON THIS /THESE BOARD(S)? I 7 / EXPERIENCE /QUALIFICATIONS RELAT D TO BOARD( APPLYING FOR e0&-r?//1 a' )7L J 4 4 'S � i ✓ICCrI i `�'LW a - r{ h n-44 2- - / s 11 , - ir 1 A resume or separate sheet additional information may be included with yoffapplication. I understand the responsibilities associated with being a board member, and I have adequate time to serve if appointed. r Aggil iVer— 10/20/2e/t7 Applicant Signa re Date Please return this application to Bonnie Wenzel, City Clerk, City of Edgewater, P.O. Box 100, Edgewater FL 32132 or drop off in the City Clerk's Office, 104 N. Riverside Drive, Edgewater FL 32132. If you have any questions please call 386 - 424 -2400. OFFICE USE ONLY Date Application Received Date Appointed to Board Board Appointed to Date Resigned from Board 2I'at,t: &Q Ci s r'OF EpG \ k d, R E pel /S AT FR EDG JUL 2 9 2011 ADVISORY BOARD – VOLUNTEER APPLICATION ClTy CLERK Thank you for your interest in serving the City of Edgewater. Your completion of this application is necessary so that the members of the City Council can thoroughly review each application as part of their consideration for the appointment. Please choose the Board(s) for which you wish to apply. If applying for more than one Board, you must number in order of your preference. ANIMAL CONTROL CITIZEN CODE ENFORCEMENT* LIBRARY POLICE PENSION* CONSTRUCTION REGULATION* RECREATION & CULTURAL SERVICES ECONOMIC DEVELOPMENT PLANNING & ZONING* FIREFIGHTERS PENSION* VETERANS PARK AVD. COMMITTEE SCHOOL SCHOLARSHIP COMMITTEE Members of the Boards with an asterisk ( *) are required to file a Financial Disclosure form within 30 days of appointment. PERSONAL INFORMATION Name V► � vl e_ 1uL( Address J .5(.7v - Pewit, b r. #Al t' V),ciut-q,e1 FL 3 3 Home Phone y N - 1, g" Log .3 ( Business /Cell Phone J66- ' SS Occupation f ` U(ak ! 44 L2 / SQX Are you a resident of Edgewater ow long Is your principal place of employment in Edgewater C--5 At the presen time, do you servp o ny other City Boards or Commissions IVU if yes, plea list each -AASIQN e.d. Yc'w S Mob 1,,S gtha Levis fit., vo Cb La a/ e-e. Have y . ever sere d on a l l y Bpards age ie or c p m m i tees ( Sif yes, ple s list each REFERENCES – Please list three business and /or personal D 0 1,t.)A..b_ Lo al& - C4c s E 1Q -( - ems Na e, a dress a d one Namur df,�d p ne /J me, address and phone 7 4e9z4-4-4—' Na !c% G �l,C(C 11Page EDUCATION 41460; (e_ 56 6*),,, g S ool ! l College e0 e 1) i j IGia,6 O e ;t7, N. 19'74 7 74 Degree(s) I S > &t, �s WORK EXPERIENCE � j 4 ( ,� i c ,���S �Y' : = S Q Ui . 75-4' C� kik ll /7r?-. ass' �� -mss - '. • O — frese-c±- INTEREST /ACTIVITIES CO MUNITY INVOLVEMENT reyr 0EC2 Ze-eX WHY DO YOU DESIRE TO SERVE ON B THIS / T H SE Or(S)? - /e7/e,aii- 6-65--e-Le est- , N4A. etit,5-7)-6(_ EXPERI "CE/QP TED TO BOARD(S) APPL ING FOR �'ar -rte � , r eS A resume or separate sheet with additional information may be included with your application. I understand the responsibilities associated with being a board member, and I have adequate time to s- e if appointed. i j / , '/ 7/Z1-1/0 .: scant Signature Date Please return this application to Bonnie Wenzel, City Clerk, City of Edgewater, P.O. Box 100, Edgewater FL 32132 or drop off in the City Clerk's Office, 104 N. Riverside Drive, Edgewater FL 32132. If you have any questions please call 386 - 424 -2400. OFFICE USE ONLY Date Application Received Date Appointed to Board Board Appointed to Date Resigned from Board 2 (1't; r , r CITY OF EDGEWATER RECEIVED EDGEWATER NOV 02 2010 ADVISORY BOARD — VOLUNTEER APPLICATION CITY CLERK Thank you for your interest in serving the City of Edgewater. Your completion of this application is necessary so that the members of the City Council can thoroughly review each application as part of their consideration for the appointment. Please choose the Board(s) for which you wish to apply. If applying for more than one Board, you must number in order of your preference. ANIMAL CONTROL CITIZEN CODE ENFORCEMENT* A( LIBRARY POLICE PENSION* CONSTRUCTION REGULATION* RECREATION & CULTURAL SERVICES ECONOMIC DEVELOPMENT PLANNING & ZONING* FIREFIGHTERS PENSION* VETERANS PARK AVD. COMMITTEE Members of the Boards with an asterisk ( *) are required to file a Financial Disclosure form within 30 days of appointment. PERSONAL INFORMATION Name m o i R 1 PucKE1 Address MAR; L ti 0 Home Phone Business /Cell Phone 3 6- 6 .gel -0727 Occupation Donble. Are you a resident of Edgewater ye how long C1 j e fiRS Is your principal place of employment in Edgewater At the present time, do you serve on any other City Boards or Commissions NO if yes, please list each Have you ever served on any Boards, agencies or committees NO if yes, please list each REFERENCES — Please list three business and /or personal f cRj . /2 Re • c +. 3* 77/7 Name, address and hone R le - V e- 6, 5 h op, t &3o Co R AIL Fa R m-S R 1 3 3 _63 -/ 3 2 2 Name, address and phone f 1 -1A1 Lt3civeR3301 i'de.DwJtRj CLub R31 a fq Name, address and phone 1 1Paue EDUCATION (q 7q High School (n I (-)171 i 5 p R !f,5,5 6 R y h 1 /nC �- P// i 5 ti/2 bo/S N College Degree(s) WORK EXPERIENCE tJ)0 R Red as q `t' /e° p hG_Z/ t° e O p e tQ ct - to N FoR /:z yPi/Rs 21 a 1- /o6pifAL ,0 FOR f} 62 7eRee4L 1 - 105p; INTEREST /ACTIVITIES k j ke -40 R e n d , do _r e. e, d /e_ f.t,r9R f( Cook c nJ b 19ke COMMUNITY INVOLVEMENT 1 f es • ' , • e- v to me, -19 fRy. WHY DO YOU DESIRE TO SERVE ON THIS /THESE BOARD(S)? T /-, f. L i hR4 y W 14.5 CA not 5 4 i L L i5 my l a WO R -1' FL n e,e 'U.e ,Ueed Come. Up wtf h moRe -fh n55 f ©R - the LibRfiRy , And rhnve 5ome+h,1155 EXPERIENCE /QUALIFICATIONS RELATED TO BOARD(S) APPLYING FOR �i woP k (.4+. my Se he L L; hR KR y /Z7eI, L Ii 51Afi -- /2)JSId P, *his u» hq / CornpufeRiu>e'Se. +hp. Cndetc ieiiReA , A resume or separate sheet with additional information may be included with your application. I understand the responsibilities associated with being a board member, and I have adequate time to serve if appointed. Applicant Signature Date Please return this application to Bonnie Wenzel, City Clerk, City of Edgewater, P.O. Box 100, Edgewater FL 32132 or drop off in the City Clerk's Office, 104 N. Riverside Drive, Edgewater FL 32132. If you have any questions please call 386 - 424 -2400. OFFICE USE ONLY Date Application Received Date Appointed to Board Board Appointed to Date Resigned from Board 2 1 I ;u< CITY OF EDGEWATER EDGETNATER RECEIVED OCT 2 2010 ADVISORY BOARD — VOLUNTEER APPLICATION CITY CLERK Thank you for your interest in serving the City of Edgewater. Your completion of this application is necessary so that the members of the City Council can thoroughly review each % Y application as part of their consideration for the appointment. Please choose the Board(s) for which you wish to apply. If applying for more than one Board, you must number in order of your preference. ANIMAL CONTROL X CITIZEN CODE ENFORCEMENT* LIBRARY POLICE PENSION* CONSTRUCTION REGULATION* RECREATION & CULTURAL SERVICES ECONOMIC DEVELOPMENT PLANNING & ZONING* FIREFIGHTERS PENSION* VETERANS PARK AVD. COMMITTEE Members of the Boards with an asterisk ( *) are required to file a Financial Disclosure form within 30 days of appointment. PERSONAL —'I INFORMATION Name FI4 1) , 64-zii e.(., Address c27 /6 (0061 / /U6 C 7 E )2/ 11 C Home Phone 177; Business /Cell Phone Occupation R- eiigt° d .5iu\1C € 19 Are you a resident of Edgewater I/ long Xea eShow lon / 2 1 � Is your principal place of employment in Edgewater 2 /i/ At the present time, do you serve on any other City Boards or Commissions Ai() if yes, please list each Have you ever served on any Boards, agencies or committees No if yes, please list each REFERENCES — Please list three business and /or personal Cox 7 E-DG 1 1 f .U-1p 9D / me, addre s and phone /NA , • e / . I L uc- /,1 De Name address and phone 23 /e.6W24 Vow/k1 28 y 649 -A GE 77 e-eg De cac 4 Name, address and phone 11 Page EDUCATION High School College '.._) - A r tssE5L) , 1 1/-1 -- (�- Degree(s) WORK EXPERIENCE AIarnA-jc L 0,0o A 1 "`` S eN ; Jig -14� N 3- ' , / , rn:Ore0 Go, c i (3ti INTEREST /ACTIVITIES Ye &A \r\ -e .ro vv∎ o 'ec- tett.ASCo, : nc), OS0.Y� P -i4\ � � COMMUNITY INVOLVEMENT � uh�A � 1 � v++�� —G A `f fZS _ ��-L3 - 1> 1.-i 2 -1)13 3 `2 Dtpy '-. WHY DO YOU DESIRE TO SERVE ON THIS /THESE BOARD(S)? _ trpG ` - Of a vaNC citivd dses,l2eca11 e,v2 a 5okrou i kkc areiLS EXPERIENCE /QUALIFICATIONS RELATED TO BOARD(S) APPLYING FOR N -Q-X perielUe,e btu t A hctV4 ND �m� re,5 - ir;1s .34- ,ly 6 f /'7 i-pp >yin y wra /r ac // DA). L ham d o ar e &AI a, o 2 6pec;'6_ % eres1 &MPr ) h CIO Ini whaf O,ppr. pr,u e a aid a II otad_ A resume or separate sheet with additional information may be included with your application. I understand the responsibilities associated with being a board member, and I have adequate time to serve if appointed. (41-1 aib, °2o / () Appli i1 nt Signature Date Please return this application to Bonnie Wenzel, City Clerk, City of Edgewater, P.O. Box 100, Edgewater FL 32132 or drop off in the City Clerk's Office, 104 N. Riverside Drive, Edgewater • FL 32132. If you have any questions please call 386 - 424 -2400. OFFICE USE ONLY Date Application Received Date Appointed to Board Board Appointed to Date Resigned from Board 2IPage _ _ " CITY OF EDGEWATER R ECEIVED EDG DES u 2010 ADVISORY BOARD — VOLUNTEER APPLICATION CITY CLERK Thank you for your interest in serving the City of Edgewater. Your completion of this application is necessary so that the members of the City Council can thoroughly review each application as part of their consideration for the appointment. Please choose the Board(s) for which you wish to apply. If applying for more than one Board, you must number in order of your preference. ANIMAL CONTROL CITIZEN CODE ENFORCEMENT* LIBRARY POLICE PENSION* CONSTRUCTION REGULATION* RECREATION & CULTURAL SERVICES v' ECONOMIC DEVELOPMENT PLANNING & ZONING* FIREFIGHTERS PENSION* \/ VETERANS PARK AVD. COMMITTEE Members of the Boards with an asterisk ( *) are required to file a Financial Disclosure form within 30 days of appointment. PERSONAL INFORMATION Name '. �c Address \, v c l ' a 1r� -- _ a 6 Home Phone "3Y , aOc∎ Business/ ri'ho e 336 690 l`S2 Occupation t p ,. L Are you a resident of Edgewater w how long ?( Is your principal place of employment in Edgewater t c) At the present time, do you serve on any other City Boards or Commissions if yes, please list each 410x6�� Have you ever served on any Bo.a,ds, agencies or committees ` S if yes, please list each REFERENCES — Please list three business and /or personal .cam ame, address and phone 11 N« J — �l�v� _ _ Name, address d phone / ( , (�c �1r ->S�( �aS�t v-1S S Name, address and phone 11Pag EDUCATION R ,c ` High School • k. r:o 4ti � - t ‘.vAQ College i-) tic C n On Ltd 1-1:4 er lAG-c Degree(s)Th� Pl\S :U yne.r-sc0- 1,12.,cc 1v is WORK EXPERIENCE FN.. Lvst..r2- t,��2�. ' `�`� �c.r'�" ' Z`S` L-- t rTA : L�►sC INTEREST /ACTIVITIES �� �`����`' S� <� COMMUNITY INVOLV1MENT -co-( a(S)c-› WHY DO YOU DESIRE TO SERVE ON THIS /THESE BOARD(S)? 7 1 1 EXPERIENCE /QUALIFICAATIONS RELATED TO BOARD(S) APPLYING FOR, C � 2;� :�- ' 1 )C - ZA - zE � Q_ON, HESS \ ' \ ,� A resume or separate sheet with additional information may be included with your application. I understand the responsibilities associated with being a board member, and I have adequate time to serve if .p,• i�� Arit-lb■ 1D- ApP S1. Date Please return this application to Bonnie Wenzel, City Clerk, City of Edgewater, P.O. Box 100, Edgewater FL 32132 or drop off in the City Clerk's Office, 104 N. Riverside Drive, Edgewater FL 32132. If you have any questions please call 386 - 424 -2400. OFFICE USE ONLY Date Application Received laNuAk0 Date Appointed to Board Board Appointed to Date Resigned from Board 2�'4ie