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Agenda 12-02-12 5B APPOINTMENTS FOR DECEMBER 4, 2012 a". Appointment Length of Term To Be Made Board Ex iration Date I Arts Commission Reg 3 yr term to 12/15 ^, II McCray Arts Commission Reg 3 yr term to 12/15 U�. 4 Mayor Hay Arts Commission Alt 1 yr term to 12/13 Tabled ) III Holzman Arts Commission Alt 1 yr term to 12/13 II McCray Bldg. Bd. of Adj. &Appeals✓ Reg 3 yr term to 12/14 Tabled (2) I Bldg. Bd. of Adj. &Appeals Reg 3 yr term to 12/13 Tabled (3) IV Ross Bldg. Bd. of Adj &Appeals✓ Reg 3 yr term to 12/15 Mayor Hay Bldg. Bd. of Adj &Appeals Reg 3 yr term to 12/15 I Bldg. Bd. of Adj&Appeals Reg 3 yr term to 12/15 III Holzman Bldg. Bd. of Adj. &Appeals✓ Alt 1 yr term to 12/13 Tabled (2) I Bldg. Bd. of Adj. &Appeals Alt 1 yr term to 12/13 I Cemetery Board Reg 3 yr term to 12/15 Mayor Hay Cemetery Bd. Alt 1 yr term to 12/13 III Holzman Code Compliance Bd. ✓ Reg 3 yr term to 12/15 IV Ross Code Compliance -✓ Reg 3 yr term to 12/15 I Code Compliance Bd. Alt 1 yr term to 12/13 Tabled (2) II McCray Code Compliance Bd. Alt 1 yr term to 12/13 Tabled (2) I Community Relations Bd Reg 3 yr term to 12/15 II McCray Community Relations Bd Reg 3 yr term to 12/15 IV Ross Community Relations Bd Alt 1 yr term to 12/13 Tabled (2) I Community Relations Bd Alt 1 yr term to 12/13 Tabled (2) II McCray Education&Youth Advisory Bd `// Reg 2 yr term to 12/14 III Holzman Education&Youth Advisory Bd ✓ Reg 2 yr term to 12/14 IV Ross Education&Youth Advisory Bd Reg 2 yr term to 12/14 IV Ross Education&Youth Advisory Bd Alt 1 yr term to 12/13 Tabled (2) Mayor Hay Education&Youth Advisory Bd✓ Stu 1 yr term to 12/13 I Education&Youth Advisory Bd Alt 1 yr term to 12/13 IV Ross Employees'Pension Bd ✓ Reg 3 yr term to 12/15 IV Ross Financial Advisory Committee Alt 1 yr term to 6/12 Tabled (2) Mayor Hay Financial Advisory Committee Alt 1 yr term to 6/13 Tabled (2) II McCray Financial Advisory Committee Reg 3 yr term to 6/15 I Financial Advisory Committee Reg 3 yr term to 6/14 Tabled (2) II McCray Firefighters'Pension Bd Reg 2 yr term to 12/14 III Holzman Firefighters'Pension Bd Reg 2 yr term to 12/14 I Library Bd. Reg 3 yr term to 12/15 II McCray Library Bd.,,/ Reg 3 yr term to 12/15 Mayor Hay Library Bd Alt 1 yr term to 12/13 Tabled (2) III Holzman Library Bd. Alt 1 yr term to 12/13 L APPOINTMENTS FOR DECEMBER 4, 2012 Planning and Development Bd✓'1 Reg 2 yr term to 12/13 Tabled (2) IV Ross Planning and Development Bd Reg 2 yr term to 12/14 Mayor Hay Planning and Development Bd Reg 2 yr term to 12/14 I Planning and Development Bd Reg 2 yr term to 12/14 II McCray Planning and Development l3d Alt 1 yr term to 12/13 III Holzman Planning and Development Bd Alt 1 yr term to 12/13 II McCray Recreation & Parks Bd Reg 3 yr term to 12/13 III Holzman Recreation &Parks fd Reg 3 yr term to 12/15 IV Ross Recreation &Parks Bd ` Reg 3.yr term to 12/15 Mayor Hay Recreation &Parks Bd Alt 1 yr term to 12/13 I Recreation &Parks Bd Alt 1 yr term to 12/13 Mayor Hay Senior Advisory d Reg 2 yr term to 12/13 Tabled (3) I Senior Advisory l3d, Reg 2 yr term to 12/13 Tabled (2) II McCray Senior Advisory Reg 2 yr term to 12/14 III Holzman Senior Advisory Bd Reg 2 yr term to 12/14 IV Ross Senior AdvisoryBd Reg 2 yr term to 12/14 Mayor Hay Senior Advisory Bd,VIAlt 1 yr term to 12/13 1 Senior Advisory Bd Alt 1 yr term to 12/13 III Holzman Special Events Ad Hoc Committee Reg 2 yr term to 04/13 Tabled (2) IV Ross Veterans Commission Reg 3 yr term to 12/15 Mayor Hay Veterans Commission Reg 3 yr term to 12/15 Veterans Commission Alt 1 yr term to 12/13 II McCray Veterans Commission Alt 1 yr term to 12/13 III Holzman Veterans Commission Alt 1 yr term to 12/13 IV Ross Veterans Commission Alt 1 yr term to 12/13 S:\CC\WP\BOARDS\APPMENTS\Board Year 2012\Appointments 12-4-12.doc APPLICANTS ELIGIBLE FOR APPOINTMENT ON 12/4/12 Last Name First Name Eli ibili Arts Com Ready Barbara Re Tito Alin Reg __ —Ir Wolf Halena Re .� �._.._..�M _ Building Board of Adjustments &Appeal Agee Beverly ReayVaxk- Guritzk Sanford RegkhdAol Gavlick -� Stanley „„- m. Alt ONLY 44 Cemqbegr Bd Glinski Bonnie Re Code Com fiance Bucella Robert __eq I Yew _1 RoseMarie Reg **Kravit Cora Reg Community w Relations Bd Newton Margaret Re *** Lentini- Marianne No Preference Bernarduci Education& Youth Adv. Bd. Alvarez Lourdes Paola Student 1 Colebrooks- Carla Reg Spencer � Kershaw Kellsie Student Lundquist Carol Reg Miller Hattie Re **LaRiccia Tony I No Preference **Newton Margaret Re Employees' I Pension Bd McDeavitt Cathleen Re Firefighters' Pension Bd BushHelen Rei �v. w._.....,.._ .._ _. _._ .a .-e Taylor I Robert Re Librate Bd Hoban Deborah Reg _ Taylor_, Jeannie I Rei �Wineberg Barbara Reg or Alt 44 Planning& Development Bd Grcevic Sharon Reg jk- -11 Kravit Cory Re SabersonRoger Reg 6 " o. _._ Recreation & .m..,,,, Parks Bd Lentini- Marianne No Preference Bernarduci Kanter Charles Reg Scantlan Catherine Reg S SeniorAdvisory Bd Lynch Katherine No Preference Preston Stuart Alt _.. Young Jean No Preference ** Lentini- Marianne No Preference ll" Bernarduci Special Events Ad Hoc Cmte _ LaRicciaToni No Preference w ,u Veterans Adviso Com Bre oli Frank Reqor Alt t4 Bowman James Re Washington Karl No Preference ** = Second Choice *** = Third Choice S:\CC\WP\BOARDS\APPMENTS\Board Year 2012\APPLICANTS ELIGIBLE FOR APPOINTMENT ON 12-04-12.doc CITY OF BOYNTON BEACHPrint Form 0ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of 4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. Name V E V C Address City State FL Zip Code Phone Number 33 .35 50 -- qdj -/SZo E-mail Address Current occupation or, if retired, prior occupation A- To �� Education D Are you a registered voter? ft Yes '(^No Do you reside within the Boynton Beach City limits?,0 Yes (-No Do you own/manage ebusiness within City limits? Yes (—No 4 "<p If"yes", name of business: A r- L L Are you currently serving on a City board? IF Yes r No Have you served on a City board in the past? eyes (-No - If so, which board(s) and when? (=dVtA n`1 I Have you ever been convicted of a crime? (^Yes i@ No if so, when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1'being the most desired and 3 being the least preferable.For board listin ,requirements,responsibilities and meeting times and dates,seepages 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning & Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers' Retirement Trust Fund Cemetery Board Firefighters' Pension Trust Fund Recreation &Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board nc Prefere s ' : e 1 st choice please select aboard... Y Ufed ilt"dl�member type , please select...;HIPL 2nd choice(optional) please select a board... member type please select... 3rd choice (optional) please select=a board.. member type please select... *If Veterans Advisory Commission,list Branch of Military Service or Organization: ' What,personal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel would make fou a good candidate for this board? Please be specific. - " a- j4wr J T-f First Choice: sL0� ` J_ KAtq .� .� Seconal Choice hird Choice: Feel free to attach an extra sheet or resume.Return the completed`form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall.Mailing address: P.O. Box 310, Boynton Beach, FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank,la file to which Commissioners may turn for candidates when board openings occur. hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed, any false statements may be cause for removal from a board. Signature: Date: d Page 2 of 4 " CITY OF BOYNTON BEACH Print Form A ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. )lease print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. Name �,,( v�V -e� I✓ ` ; C3��C� - Address 1 t%Alr C L City State FL Zip Codej j( j Phone Numbe ,(,) �- 1 E-mail Address ec GL 1 G � � t� haa� Current occupation or, if retired, prior occupation - ' Education & Are you a registered voter? (^Yes (-No , Do you reside within the Boynton Beach City limits? ( Yes C' No r.3 Do you own/manage a business within City limits? (`Yes t%-No z �n c::) If"yes", name of business: V CD Are you currently serving on a C y board? (`Yes (�_No `tea Have you served on a City board in the past? (^Yes d1 rn If so, which board(s)and when? l n rn l�� X Have you ever been convicted of a crime? (`Yes (�-No If so, when? ��/~ Where? �Ovlt - You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,see pages 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning & Development Board Building Board of Adjustment&Appeals Employees' Pension Board Police Officers' Retirement Trust Fund Cemetery Board Firefighters' Pension Trust Fund Recreation & Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* i Board Preferences: 1 st choice please select a board... fC61( member type please select... 2nd choice(optional) please select a board... member type please select.. rd choice(optional) please select a board... / member type please select.. If Veterans Advisory Commission, list Branch of Military Service or Organization: ° What personal qualifications doyou possess (ie, pnofeookon, previous eupehence, branch of military service ororganization)which you feel would make you a good candidate for this board? Please be specific. P)6 0 61A 06 Its First Choice: `--� ^ =" �~~� ^�� m �sk �V� V Second Choice: .nird Choice: Feel free hoattach onextra sheet orresume. Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall. Mailing address: P.O. Box 310, Boynton Baoch, FL33435-O31O FAX to: (5G1) 742'G89U It will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. | hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed, any false statements may because for removal from aboard. Signature:', Date: Page 2of4 1L/U.D/ZU1Z lU;46AR kA4 0U1UU4VZ4Z0U1 SU4VZ4L hi It 0002/0005 CITY OF BOYNT ON BEACHllzx!,, �u,,�i; �' .I ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of 4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board,selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety, the form will be returned for clarification. Name Marianne Lentini-Bemarduci ....... .,,. Address 2453 SW 23rd Cranbrook Drive City Boynton Beach State FL Zi { 9 P Code 33436 Phone Number 561)632. 891 E-mail Address mlentini@evidenoepi.com _ ..,,, ........ Current occupation or, if retired, prior occupation Private Investigator/business Owner Education B.A. Legal Studies L.,.. Are you a registered voter? Yes �',No Do you reside within the Boynton Beach City limits (o-Yes C:No o -<4 Do you owntmanage a business within City limits? r Yes !"No m t rnLn a' If"yes",name of business: Evidence Investigations, Inc. ' Are you currently serving on a City board? (''.Yes ( -No ..._. � ..C:)z Have you served on a City board in the past? (".Yes {:,No t.i If so,which board(s)and when? — lave you ever been convicted of a crime? C''Yes t+.:N """"' """"" o ....., If so,when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member, alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board listinc,requirements,responsibilities and meeting times and dates,see pages 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning&Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers'Retirement Trust Fund Cemetery Board Firefighters,Pension Trust Fund Recreation&Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences: 7 st choice Recreation&Parks Board — member type No preference 2nd choice(optional) Senior Advisory Board member type No Preference 3rd choice(optional) Communfty Relations Beard member type No preference "If Veterans Advisory Commission,list Branch of Military Service or Organization;L 14tV0/LU1L IU:JaAX kAA D01U04VZ4LD61J04VZ4L Et Ilm 0003/0005 What personal qualifications do you possess(i.e., profession,previous experience,branch of military service or organization)which YOU feel would make you a good candidate for this board?Please be specific. As both a resident and business owner in Boynton Beach, I feel a duty to ensure it is a vibrant,safe,and fun Place to live and work. First Choice; 1 am an active person who is very interested in keeping our residents healthy, happy and able to enjoy this won NJ city. Second ChoiceFconcemr the senior population has always been near and dear to my heart, I am especially interested in stopping elder care fraud and abuse. ...... _.,. ..... .......... 'hird Choice: I am certain my skills could be of value in making the city of Boynton Beach a safer,healthier and more secure place to live. Feel free to attach an extra sheet or resume.Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall, Mailing address: P,O.Box 310, Boynton Beach, FL 33425-0310 1)742-6090 It will be placed in the City's Talent Bank,a file to which Commissioners 9 ssioners may turn for candidates when board openings occur. I hereby certify that the statements a answers provided herein are true and accurate. I understand that, if appointed,any false statements may be cause for removal from a board. Signet Date: %4S \ Page 2 of 4 11/05/2012 10:39AN FAX 56136492425613649242 EI IM 0004/0005 MA.RXAN E LENTXNX 2453 SW 23W Cranbrook Drive Boynton Be ca h,Florida ��10Sm �5�� 33436 mlp%x2pgrr►siil.com SUMMARY Or QUAx zFICATIONS ► Highly skilled and dedicated Private Investigator offering an impressive 20 year bac investigation of critical issues for the legal, insurance, business and risk management industries. Qualified to deliver the programs, processes and systems neccssary for success. Bxpertise in a wide range Of investigative services and methodologies,including compliance to local,state and Federal regulations. ► Outstanding communication, organization and interpersonal skills, written and verbal. Facilitate communications at all levels of the organization, develop motivated and productive teams,and produce quality documentation.Cultivate long-term customer commitments through superior client services. ► Computer proficient in Windows XP,Microsoft Office,and the Tnternet. Areas of Expertise ► Regional&Accourxts Management ► Sales&Marketing Growth/P&L ► Research&Investigative Techniques ► Legal&Corporate Compliance Structures ► Corporate loss Prevention Strategies ► New Business&Competitive Market Targets CAREER BACKGROUN.0 President - Evidence Invebligations,Inc. JAY 2003— present ► Direct sales and operations for this highly respected investigation firm specialising in surveillance and investigations for insurance carriers, attorneys, government agencies and corporate industries. Case manage investigators,and supervise as needed. ► Deliver a wide range of investigative services, including: Claims Investigations; Surveillance; Witness Locates; Field Interviews & Statements; Pre-employment Screening, Workers' Compensation Claims; Accident Scene Investigations; Liability & Disability Claims; Life & Health; Background Checks, and Database Investigations,among others. ► Market investigative services to law practices, businesses, infiuranec companies, government entities and third party administrators throughout the state of Florida. Research and develop leads and initiate contact with potential clients. Work closely with accounts to assess their investigative needs, and formnulate comprehensive service plans to best resect these.goals. ► Maximize revenue, market share, and new business growth through extensive industry knowledge and creative selling strategies,incorporating strong negotiation,and packaging skills.Increased business by 5o% within the first year. Owner&Operations Manager Accurate Detective Agency,LLC,Cheshire,CT February 1991—June 2001 ► Established and built this highly successful private investigation firm specializing in legal, business and personal investigations of potential theft and fraud cases. Personally performed a wide range of undercover investigative operations. ► Recruited,trained and supervised a professional team of investigators and surveillance specialists. ► Cultivated,secured and maintained a solid base Of clients within state agencies,and legal,corporate,and insurance industries. ► Grew business to generate$500K in annual revenues,operating on a part-time basis. ► Managed all business operations related to running a private firm, including direct oversight of sales, marketing,compliance to legal and industry standards,and delivery of quality client services. Private Investigator Pioneer Adjustment Service,Hamden,CT ► Led and directed a s May x991—June goof pccial investigative unit of investigators and surveillance specialists generating approximately$$SoKin annual.revenue. 1L/05/2012 1U:39AM FAX 56136492425613649242 EI 16 0005/0005 ► Ensured unit and individual compliance to corporate and legal standards, Reviewed Practices liv reporting structures. Implemented procedures for improved performance and quality of product delivery,I�cntorcd investigators and acted as a liaison between clients and team, ► Conducted surveillance,activity checks and background investigations on auto, Workers'Compensation, and general liability claims, Private Investigator Security Service of Connecticut,Bridgeport,Cr ► Conducted all bac and c August i9$9 i February iggx background investigations, including: employee background checks,uninsured motorists, and Workci�s'Compensation claims. EDUCATION&CERTIFICATIONS Qunnipiac University,Hamden,C1' - ► Bachelor of Arts:Legal Studies Lasell Junior College,Newton,MA ► Associate of Arts: Liberal Arts The Kcnts Hill School-Kcnt's Hill,ME ► Certified in Insurance Investigation,Missing Persons, Background Checks,and Asset Searches, ► Licensed and bonded Private Investigator ► licensed all lines insurance adjuster PROFESSIONAL,ASSOCIAATIONS ► Risk and Insurance Management Society —� ► National Association of Sales Professionals ► Florida Association of Licensed Investigators ► National.Association of Legal Investigators ► Charter Member; Board of Directors:Connecticut Association of Licensed Private Investigators ► Association of Certified Fraud EYeaminem The finest in professional references to be ficrnished once mutual interest is established. CITY OF BOYNTON BEACHPrint Form 0 ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. Name - F 'Z .Address © � r�' City 0 `O State TFLZip Code3134 Phone Number 3 ""'� E-mail Address Current occupation or, if retired, prior occupation �do�,/ Education 4AS /76ZW .�`.cl—/ 144Y � Are you a registered voter? es (-No Do you reside within the Boynton Beach City limits? t^Yes f No Do you own/manage a business within City limits? (^Yes No If"yes'; name of business: Are you currently serving on a City board? yes ( No Have you served on a City board in the past? Yes i^No If so,which board(s)and when? VC-7_;Fr.A--1 Z V15c9/L1 ' nave you ever been convicted of a crime? f^Yes (^N •�—• 2� If so,when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1being the most desired and 3 being the least preferable.For board listin ,requirements,responsibilities and meeting times and dates,see;pages 3 and 4 below, Arts Commission Education and Youth Advisory Board Planning &Development Board Building Board of Adjustment&Appeals Employees' Pension Board Police Officers' Retirement Trust Fund Cemetery Board Firefighters' Pension Trust Fund Recreation & Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences, 1 st choice please select a board... Vr? V/,rOR y7,Ja4A0member type please select... Olsen- 2nd choice (optional) please select a board... member type please select.,. V1 So qN t ;rd choice(optional) please select a board.., member type please select... *If Veterans Advisory Commission,list Branch of Military Service or Organization: �' t 0,"Vhat personal qualifications do you possess (i.e., profession,previous experience, branch of military service or organization)which you feel would make you a good candidate for this board? Please be specific. . AA M\( Z YEA 2`r r-n v/Ccs,,. 9 A&J )c �-c t 1 f c®A r- 4'UA, t b AU71" 12.yF, tt,r .c�� ce- First Choice: !«4 '®'u� ARY LL,e} '9A.r — J�a'� -.o aJ c, L.,, A-1 til c-Api Le ey a<as✓ ?I+GrC` U (iC�" + D�.rL '%`''may ! YG,sA_IC.. ew dee" CAML ACLI J-4 ®� Second Choice„f bird Choice: Feel free to attach an extra sheet or resume. Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall. Mailing address: P.Q. Box 310, Boynton Beach, FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank', a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed, any false statements may be cause for removal from a board. Signature: Date: a Paget of 4 CITY OF BOYNTON BEACH Print Form <" .ADVISORY BOARD APPOINTMENT APPLICATION �' Page 1 of 4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be ,,rioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. Name 17 P Addressa R 2-0 "fS - tom{V_r_ own City State FL Zip Code 3 jl� � Phone Number E-mail Address Current occupation or, if retired, prior occupation Education / s1 /►�+37LJ Are you a registered voter?Xe5 (^ No Do you reside within the Boynton Beech City limits? Yes 1^No _ Do you own/manage a business within City,limits? lyes ("No o If"yes", Warne of business: � _ /max` 7j9cz Are you currently serving on a City board? es (^No —0 fr Have you served on a'City board in the past? , Yes ( No , If so, which board(s) and when? � 7 G��' , [v r c-) .ave you ever been convicted of a crime? (,Yes XP If so, when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1;being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,see pages 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning &Development Board Building Board of Adjustment&Appeals Employees' Pension Board Police Officers'Retirement Trust Fund Cemetery Board Firefighters' Pension Trust Fund Recreation &'Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences: 1 st choiceplease select a board... �rt3 member type Fp/ease select,.` 2nd choice(optional) please select a board.., member type please select... rd choice (optional) please select a board... member type please select... If Veterans Advisory Commission, list Branch of Military Service or Organization; What personal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel would make yousa good candidate for this board?Please be specific. First Choice: / M.4J'K ✓ � � G��f C? '� �o( - /7. ; 1-522 14 - � Second Choice hird Choice: Feel free to attach an extra sheet or resume.Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall Mailing address: P.O. Box 310, Boynton Beach,FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur, I hereby certify that the statements and answers provided hereinare true and accurate. I understand that, if appointed,any false statements may be cause for removal from aboard. Signature: Date: r . r i Page 2 of 4 Commander James Bowman Curriculum Vitae (561) 667-3431 JBFINS@hotmail.com 2005-Present—District Director Boy Scouts of America—Gulf Stream Council - Coached and Mentored over 100 Volunteers- Managed professional staff in mentoring and leading youth. Organized Community events in raising over 1.5 Million dollars for Local Scouting Programs— Engaging National and Local personalities including Dick Morris, Tim Tebow, Dr. Edgar Mitchell (Sixth Man on the Moon),Judge Richard Wennet and Sheriff Rick Bradshaw, as event hosts and speakers. Manage Scouting Programs throughout Palm Beach County-including Boynton Beach/Lake Worth/Green Acres/Palm Beach/West Palm Beach/Riviera Beach/North Palm/Palm Beach Gardens/Jupiter and Tecluesta. 1997-2001 Director of Corporate Partnerships-Job Corps for State of Florida - Opening door to career opportunities for over 1,200 students at 5 Job Corps Centers-Initiated, Organized and Coordinated MOAs/Partnerships between 20 Fortune 500 Corps in Florida and Job Corps to establish internships and work based learning opportunities for Florida's Youth. 1992 -Present—Commander, Naval Reserve, Supply Corps—Currently Commanding Officer of VTUO81OG at Navy Operational Support Center West Palm Beach Veteran of Operation Enduring Freedom Post 9-11, Presidential recall for 1 year mobilization to Guantanamo Bay, Cuba Detainee Operation Served as Public Affairs Officer and Logistics Officer in Charge of Operations and Hometown News Coordinator/Media Liaison Radio Host GTMO Armed Services Radio Adjunct Business Professor- University of Chicago- Business Management+ International Business For accomplishments achieved during GTMO mobilization, was awarded the Navy Commendation Medal and Global War on Terrorism Ribbon. Letter of Commendation from Chief of Naval Information Letter of commendation from Congress Letter of Commendation from Jimmy Buffett, for coordinating his tour and performance at GTMO Currently authoring first book—GTMO:The Real Meal—reflecting the GTMO experience. 1995.2002 Contracting Officer- Held numerous multi-million dollar contracting warrants. Managed $10 Million Navy Rotary Wing Aircraft program. (DAWIA Level 2 Cert) 2009—2011- US Naval Academy Blue and Gold Officer - Mentored 18 candidates 2009 +2010 Appointed to Senator LeMieux's Naval Academy Selection Board 2009—Present—Navy Supply Corps Interview Officer International Relations- Represented Navy for missions and exercises in 7 overseas nations during 19 year career. Military Decorations include: Navy Commendation Medal (2) Navy Achievement Medal Defense Service Medal (2) Global War on Terrorism Overseas Service Junior Officer of the Year Nominee (ROA) (2) Certifications Held: USCG-Certified Master/CAPT-25GT Dive Master-PADI 2010—Present—Boynton Beach Veterans Council—Currently spearheading mission to rename PBIA, to CAPT David McCampbell International Airport, after Palm Beach County's own American Hero and WWII Medal OF Honor recipient. Memberships Include: 2005-Present—Committeeman Palm Beach County- Republican Executive Committee Navy League of Palm Beach,former VP Programs engaging former Assistant Secretary of Defense Admiral Tom Moore as featured speaker American Legion Post 164 SWIMS Foundation— Board Member—Organize funding for free swimming lessons for children of Broward County Amara Shrine Kiwanis Club Hispanic Chamber of Commerce (Bi-Lingual—Spanish) Hobbles: Entertainer—"The Singing Sailor" Frank Sinatra Tribute Show, with special performance of God Bless the USA—Dedicated to our troops around the globe, protecting our way of life! Performance venues have included—Mara Lago, Sailfish Club-Palm Beach, Beach Club-Palm Beach, Abacoa CC-Jupiter, Atlantis CC, Broken Sound CC-Boca, Hutchinson Island Hilton, Bella Cucina-Jupiter, Cugini-Delray, Westchester CC and Resorts International-Atlantic City, For More Info visit www.SingingSailor.com uct,it 1Z iu:vya Kooert ivi. rsuoeua 561-375-9009 p,2 CITY OF BOYNTON BEACH LPrint Form ' ADVISORY BOARD APPOINTMENT APPLICATION Paget of4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type ail answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. Name Robert M. Bucella Address 519 Live Oak Lane City Boynton Beach State FL Zip Code 33436 PhoneNumlerl (561)704-8979 E-mail Address robo22@bellsouth.net Current occupation or, if retired,prior occupation Retired Law Enforcement Education BIA University of Memphis Are you a registered voter'? (a Yes ( No Do you reside within the Boynton Beach City limits? t:Yes ( No Do you own/manage a business within City limits? (-Yes (o No If"yes", name of business: 'NIA Are you currently serving on a City board? t:Yes ('No Have you served on a City board in the past? {:Yes r No If so, which board(s)and when? Code Compliance ,,ave you ever been convicted of a crime? C Yes (:No If so,when? NIA Where? NIA You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize upto three choices with number 1 being the most desired and 3 being the least preferable.For board listing„requirements,responsibilities and meetin times and dates,see pages 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning&Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers'Retirement Trust Fund Cemetery Board Firefighters'Pension Trust Fund Recreation&Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Prefierenc-m: 1 st choice I Code Compliance Board member typeRegutar 2nd choice(optional) #ease select a board... member type please select.. 3rd choice(optional) please select a board... member type please select.. "If Veterans Advisory Commission,list Branch of Military Service or organization: Oct 17 12 1U:1Ua Robert M. Bucella 561-375-9009 p.4 Robert M. Bucella 519 Live Oak Lane Boynton Beach, Florida 33436 561-375-9009 robo22@bellsouth.net EMPLOYMENT EXPERIENCE Februa y 2008 - Present RETIRED U. S. Customs &Border Protection August 2002 - February 2008 1 East 1P Street#323 Riveria Beach, FL 33404 *Senior Officer (GS-11) Responsibilities include: - Keeping America.'s borders safe and secure from terrorists, illegal materials, while also facilitating the flow of legitimate trade and travel. - Monitoring and recording international flights of aircraft in and out of Palm Beach International Airport. - Performing the duties of former Customs Inspectors,Lnmigation Inspectors and Agriculture inspectors. Arrest and prosecution of offenders and violators of the laws of the United States, as well as state,county, and municipal. - Team leader in conveying the orders of supervisors to fellow officers. JeM Mink PhoLography November 1999-August 2002 9400 Glades Road Boca Raton, FL 33434 Photographer -Photograph social occasions (weddings, birthday etc.) -Plan, organize, and direct special social functions Oct-17 12 10:11a Robert M. Bucella 561-375-9009 p.5 Page- 2 Professional Securitv Bureau Februa 1998-November 1999 88 Park Avenue Nutley, N.J. 07110 * Chief of Investigators Responsibilities included: - Supervise, schedule and assign investigators& security officers - Review and approve reports of investigators and security officers - Provide executive armed protection for corporate clients. - Conduct criminal and civil investigations for corporate clients including but not limited to thefts, insurance frauds, witness statement and surveillance. Februa 1997 - Februa___ 1998 -_RET1 tED West Orange Police Department September 1971 - Februan 1997 66 Main Street West Orange, N.J.07052 *Police Sergeant Responsibilities included: - Manage Detective Bureau - Formulate Division annual budget - Assign, instruct and evaluate Detectives - Conduct background investigations of police candidates - Investigate crimes of serious nature/high profile -Detection, collections and preservation of physical evidence for presentation at trial of suspect(s). - Manage uniform street police officers - Investigate MV accidents, issue citations, provide emergency treatment to injured. Oct,,17 12 10:11a Robert M. Bucella 561-375-9009 p.6 page -3 EDUCATION University of Memphis-Bachelor of Arts-Law Enforcement Federal Law Enforcement Training Center-US Customs Inspector Essex County N.J. Police Academy-Basic Police'Training Essex County N.J.Police Academy-Basic and Advanced fingerprinting. Essex County N.J. Police Academy -Basic and Advanced photography_ John Jay College -Interview and Interrogation Adelphi University -Narcotic Rehabilitation Programing Bergen County Police Academy N.J. - Instructor CITY OF BOYNTON BEACH Print Form ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. Name - Address U . ter' CityB,o _I State FL Zip Code[3 Phone Phone Number E-mail Address h ,b ey r`i e� e Current occupation or,if retired, prior occupation f� Education ] , Y 57 L,7 Are you a registered voter? VYes ('No Do you reside within the Boynton Beach City limits? Yes C Nn ' Do you own/manage a business within City limits? ('Yes ("10" If"yes", name of business; Are you currently serving on a City board? es {-No cn Have you served on a City board in the past? (`Yes ('No If so,which board(s)and,when? r' 5 ' �' ( ? ! r�. ! � ,�- s �� iia � '� �s � �u•y C-1 Have you ever been convicted of a crime? (^Yes (fXo' �I 0 If so,when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular,member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,see;pages 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning & Development Board Building Board of Adjustment&Appeals Employees' Pension Board Police Officers'Retirement Trust Fund Cemetery Board Firefighters' Pension Trust Fund Recreation &Parks Board Code Compliance Board Golf Course p o Advisory,Committee Senior Advisory Board Community Relations Board Library BoardVeterans Advisory Commission* Board Preferences: 1 st choice please selec a board... memper type fpease select., F--1 Y7e-7-/5-1117e'i^ 57* r7 )I W F u li r ly1 2nd choice(optional) please select'a board... member type please select.. )rd choice(optional) please select a board... member type please select:.. *If Veterans Advisory Commission,list Branch of Military Service or Organization: What personal qualifications do you possess (i.e., profession, previous experience,branch of military service or organization)which you feet'would hi,%,ake you a good candidate for this board?Please be specific. h p S S O Lem ,-1 p r S/�y l �' ' ! 7-7- Q..7 S 12 First Choice: 7W r " ' 7 9 c Q �M A7 !40-7se 6). 71 -&,r o -- 5,5-oc . T emu a l � �� p 7 d r ,s� CO s-, tr—/O w X�;P' Second Choice: r, --7 1/el hird Choice: Feel free to attach an extra sheet or resume. Return the completed form to City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall. Mailing address: P.O.Box 310, Boynton Beach,FL 33425-0314 FAX to: (561)742-6090 It will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. 1 hereby certify that the statements and answers provided herein are true and accurate. 1 understand that, if appointed, any false statements may be for removal from a board. Signature: Date: Page 2 of 4 CITY OF BOYNTON BEACH Print,orm ei ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of 4 I ar yc�u for your Interest�n serving on, I ity advisory board and for to in ,.the tune to fi out this forrrl �e ' etrtz R�st e� Iel lfnterest,js expr' ' ed rn, Fl`ffinenod fa ori osier' e 'tins 'u'f ,,; itI'll, 11 n t ;, rorli 2,tftn trot,enfi;;y ' oYfIo rthe ilxir °I ritiiied' til 'ats3r t ii' �^ >alwd ply , . n i, ..y t fnr i tie ref . f tciarrtiir �Y� a jai Z i ee`: u t a ar f �t ry k k r i ttS +� RM Addre ,. t m };` s J4,. a �- ; date i..�t:fi 1}f, �{F4Y��; js ,Y,-. „1`, -,.YOV, it ) ,,i:. t}I,,,;: ` it ,( }C ti .I(, , �tr '�t{V4t� ��t�ae�t �Ka„;�i�}� fit.tl� v..3 �MalirA'd 1, ', „U.,t } la i.£} �� s 9y � r � ( i, itct 5 W11, , s }t ! o°hod ron�tngs� j t tr I1Tnre areroif3Jerr� sberl : '^` fo v�yo,6served en,' ibard�n psties t" le If o, Ibit, 77 bxaar�t(�j axtd'�YUheta ier =yveteh crlvtct�eyflfriie? ",X�s o q� }� 4 � �'od tr�ay:'serve�in Q.nly one`b©atd Plea��indicate wrl�ich ad�isbry bt�ar';d(,��,you are�ee'ktng a°po�ntm,�nt,Afit� aar'hetta�r asa r'egul r £erdbsr,alt rnate, xrao prrrfer n'c Priorit7,te uptiott�'fie `ths��ces'w�tti`a�uxnber`7`being$I�ae mos rdesired' ra l ingAeteas't �r�ter�alle Fer`ba�rd��star� ;�xe�:ui're'Faaents,res�ons�i�iltn�xannid�rneet�T.gt�r�riar�fi.�at�s4��ee,�� e3��r��4�faeltivu., , Ar��rl�nt��a©n Educa�it�r�and Yt,th;�duiat�`�r�oard P,��t�nirag &,Dev�lst�m�r,�tr�Board 8w�dt toardafAdjestmur#i�Appealstnptbyees',Pns�orrd Polioffioer "RRt;irt�er>tr ;;t*und er every oarFirefaghtrers''Pet t� .Trust; vnd Recr tin " ?eiiis �o i a►rtpli rice Board G''olf Course A6,js,0ry` 4.rrarn ttee 7. �eiaier Adulsor hard �Comr urfty 14,e! tions"Board library,S arts �/e#erans A��sor mta is io * Bo rtP�Rehm e est chdie p16se selef a board (' �, membet +pe Owl ber 2nd choice(optionell please select a boa imernbei type please select,'.. ZZ. . 3rd choice{optional) please select a board., Mernber tyke tease select... ` If Veterans Advisory Commission,list Branch of Military Service or Organization; What,p_ , .al qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel w*juld make you a good candidate for this board? Please be specific.Ct Irn an educatvr` +� !�e 'a� First Choice: P11 JI Ucal o�" fel,"r.0 AV1 MW, Itm .:or Second Choice,i hird Choice; Feel free to attach an extra sheet or resume. Retum the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall. Mailing address: P.O. Box 310, Boynton Beach, FL 33425-0310 FAX to: (561)742-60g0 It will be placed in the City's Talent Bank,''a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein'are true and accurate. l understand that, if appointed,any false statements may be cause for removal from a board. Signature: ♦,/ • Date: Page 2 of 4 CITY OF'BOYNTON BEACH PrintFb m ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Blease print:or type all answers clearly. If interest is expressed in appointment to snore than one board,;selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification, ..Dame Address ht—STA City - - State FL Zip CodeMz Phone Number, �? E-mail Address a � " Current occupation or,iretired,' nor occupation CDS Education 3' } Are you a registered voter? Yes f No Do you reside within the Boynton Beach City limits? Yes C'No tv Do you own/manage a business within City limits? { Yes No If"yes";;name of business: Are you currently,serving on a City board? fdYes {`No Have you served on a City board in the past? 11Ye's (^No If so,which boards)and when? uI., IUK9,4WM IE�" �10 Have you ever been convicted of a crime? (^Yes No' If so,when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choiceswith number 1 being the most desiredand 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,see pages 3'and 4 below, Arts Commission Education and Youth Advisory Board Planning &Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers'Retirement Trust fund Cemetery Board Firefighters'Pension Trust Fund Recreation & Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* �B�oard �Preferences: 1 st choice please select a board.., member type please select... 2nd choice (optional) please select a board... member type please select... ird choice(optional) please select a board... member type please select... •If Veterans Advisory Commission,list Branch of Military Service or Organization: What personal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel would make you a good candidate for this board? Please be specific. First Choice: Second Choice' ,'Mi it d Choice II Feel free to attach an extra sheet or resume.Return the completed form to; City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall. Mailing address:P.O.Box 31.0, Boynton'Beach, FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank,a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true nd accurate: I understand that, if appointed,any false statements may be cause for rem al from a board. Signature: Date: Page 2 of 4 CITY OF BOYNTON BEACH Print Form ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to snore than one board, selections must be prioritized, If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. Name ,ve— / G./< Addressr 1 41S city State FL Zip Code Phone Number E-mail Address11 sr*v 5yi f✓ G a.��.¢ ,�v 7- Current occupation or, If retired, prior occupationN�lv , � Education BRyf1 Z' � L c U F13 Are you a registered voter? es f^No s. a N,3 Do you reside within the Boynton Beach City limits? Yes C�p < t DQ you own/manage o business within City limits? {^Yes o �b If"yes", name of business: ?Z Are you currently serving on a City board? (P es C NoTico - Have you served on a City board in the past"? i�es ('No w -3 If so, which board(s)and when? l/C7'i�<,c1,''j AAvOc AY Have you ever been convicted of a crime? t'Yes'' 9<0 If so,when? Where? You may serve on only one board. Please indicate which advisory boards)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,see;pages 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning &Development Board Building Board of Adjustment&Appeals Employees'Pension Board " Police Officers' Retirement Trust Fund Cemetery Board Firefighters'Pension Trust Fund Recreation &Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board' Veterans Advisory Commission* Board Preferences: 1 st choice please select a board.. member type please selects 01✓lSal� 2nd choice(optional) please select a board... member type please select.., e)rd choice(optional) please select a boars'... member type please select... *If Veterans Advisory Commission, list Branch of Military Service or Organization: What personal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel would make you a good candidate for this board? Please be specific. AM 441,fA First Choice: �9 cls i4d ' ! �2 Y e T !!G / ' �' �i c�� ✓L J Second Choice° ,'hint Choice: Feel free to attach an extra sheet or resume. Return the completed form to: City Clerk's Office, 100 East,Boynton Beach Boulevard, City Hall.'Mailing address: P.fl. Box 310,Boynton Beach, FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank,a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed,any false statements may be cause for removal from a board. Signa e: Date: Page 2 of 4 CITY OF BOYNTON BEACH Print Form ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form, Please print or type all answers;clearly. If interest is expressed in appointment to more than one board,selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. Name 130nnl-e I n's Address City State FL Zip Code T 'i Phone,Numb 7 " - l E-mail Address Current occupation or, if retired; prior occupationt?� �e Education t xYCt DY -S l 1 c c cs /lei r C cif 16 Are you a registered voter? Yes (-"No Do you reside within the Boynton Beach City limits? Yes " No Do you own/manage a business within City limits? f^Yes XNo r-cv If"yes", name of business: Are you currently serving on a City board? Yes ('No CD Have you served on a City board in the past? r Yes ('No c,7 -,a) If so, which board(s) and when? - t11,S d�' (�j pct f-c. Q&a ' riave you ever been convicted of a crime? (-Yes No If so,when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three'choices'with number 1'being the most desired and 3 being the least i preferable.For board listing,requirements,responsibilities and meeting times and dates,see pages 3and 4 below. Arts Commission Education and Youth Advisory Board Planning &Development Board Building Board of Adjustment &Appeals Employees'Pension Board Police Officers'Retirement Trust Fund Cemetery Board Firefighters'Pension Trust Fund Recreation &Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences: 1st choice please select a board... C eemy" - t)4 member type please select;.. 2nd choice(optional) please select a board... member type ; please select... Ord choice(optional) `please select'a board... member type please select.. ` If Veterans Advisory Commission,fist Branch of Military Service or(Organization: What personal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel wbuld malke you a good candidate for this board?Please be specific. Cl P1 T-0 b 160 First Choice: �- ir ) - d Second Choice hird Choice: Feel free to attach an extra sheet or resume. Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall. Mailing address: P.O Box 310, Boynton Beach, FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. l understand that, if appointed,any false statements may be cause for removal from a board. Signature: Date: 1d f Page 2 of 4 CITY OF BOYNTON BEACH Print Form ADVISORY BOARD APPOINTMENT APPLICATION Pagel of 4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answersclearly. If interest is expressed in appointment to more than one board, selections must be prioritized. if instructions are not followed or the application is not filled out in its'entirety,the form will be returned for clarification. Name Address City u State FL Zip QodeF3 3 Phone Number 5 , E-mail_Address �'-�'�! 0 Current occupation or, if retired, prior occupation F Education Are you a registered voter? g yes ,(-No Do you reside within the Boynton Beach City limits? Yes r No Do you ownlmanage a business within City limits? &YeS (-No C-) If"yes", name of business. w, t " ;0-K Are you currently serving on a City board? Iles C'No "X Have you served on a Cit board in the past?Y Y p � a Yes ( No If so, which board(s) and when? ut nave you ever been convicted of a crime? {^Yes -6 No If so,when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three''choices with number 1 being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,see pages 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning &Development Board Building Board of Adjustment &Appeals Employees'Pension Board Police Officers'Retirement Trust Fund Cemetery Board Firefighters'Pension Trust Fund Recreation & Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences: 1 st choice please select a board... � V member type please select... P'rgN)A'JS 2nd choice(optional) please select a board... member type please select... ird choice(optional) please select a board... member type please select.. *If Veterans Advisory Commission,list Branch of Military Service or Organization: What personal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which ' you feel would make,you a good candidate for this board? Please be specific. First Choice: - V Second Choice hird Choice: " Feel free to attach an extra sheet or resume.Return the completed form to: City Clerk's Office, 1 00East Boynton Beach Boulevard, City Hall. Mailing address: P.O. Box 310, Boynton Beach,FL 33425-0310 FAX to: (561)742-6090 It Will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that,if appointed, any false statements may be cause for removal from a board. Signature: Date: l Page 2 of 4 CITY OF BOYNTON BEACH Print Form ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be retumed for clarification. Name e bah Address U a At U.) Gl9 ky Ci#Yov1, dy1 G State Ft, Zip Code 33�Fab Phone Number �� E-mail Address 0.v * ed U- Current occupation or, if retired, prior occupation 0 hi y p ilrl 0.n'' Education BA Are you a registered voter? les r No Do you reside within the Boynton Beach City limits? Eyes r No rt Do you ownimanage a business within City limits? (—Yes ao C-) If"yes", name of business: Are you currently serving on a City board? I Yes C,No t-SCD Have you served on a City board in the past? (-Yes "lo �? If so,which board(s) and when? L. i 'br(xry e 0. a2' I1 D .101 Z c:) t"n� Have you ever been convicted of a crime? {^yest >I o If so,when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1`being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,see pages 3 and 4 below, Arts Commission Education and Youth Advisory Board Planning &Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers' Retirement Trust Fund Cemetery Board Firefighters' Pension Trust Fund Recreation&Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences: 1 st choice please select a b rd... member type please elect... 2nd choice (optional) please select a board... member type please select.. 3rd choice (optional) please select a board... member type please select... *If Veterans Advisory Commission, list Branch of Military Service or Organization: What personal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel would make you a good candidate for this board? Please be specific. _- anti c v rrye�n. 1 ke a d o f 5er'l oa i s o ci v i s j 4 i o n 1'�ana e M erre' a t F/o a. / f a n r'c OA Vt r s /'j-/� First Choice: W l �ry1, 1 �,.� bra r;e-.5 . h4K --Aa42.(1 s 4-ck4 us as GC ()n Y 1i 6 raV-i ch n ^rut C a trx 4 e K& -01�, irs e.G 'i Vf- C9 n acaje #6 i b;l^art board , ' Innld ao dea f�b � a • f r Second Choice a hird Choice: Feel free to attach an extra sheet or resume.'Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard,City Hall. Mailing address: P.O. Box 310, Boynton Beach, FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank,a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed, any false statements may be cause for removal from a board, Signature: Date: f Page 2 of 4 CITY OF BOYNTONEACHrintFor 1 r ADVISORY BOARD APPOINTMENT APPLICATION Page 1 oft hank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. if interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety, the form will be returned for clarification. Name Charles E. Kanter y _ Address 12905 South Greenleaf Circle City (Boynton Beach :tate IFL Zip Code 33426 Phone Numberl (561)369-7828 E-mail Address 1kanter_c@bellsouth net Current occupation or, if retired, prior occupation Marine Surveyor(Ret.2010) Publisher, writer, lecturer, trainer. Education 1BA, SUNY New Paltz, Post graduate. Columbia University, College of William Bary Are you a registered voter? t;� yes `_ No e a Do you reside within the Boynton Beach City limits? , yes No - _ Do you ownimanage a business within City limits') ;« Yes No r a., if"ves" name of business. iSAILCO Press Are you currently serving on a City board? (i Yes :°""No Have you served on a City board in theast `� g" p ? (,-, Yes No If so. which board(s)and when?! Have you ever been convicted of a crime's (-Yes t.No If so, when? A"re? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular ,mernber,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.€or board listing,requirements,responsibilities and meeting times and dates,see pages 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning&Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers' Retirement Trust Fund Cemetery Board Firefighters'Pension Trust Fund Recreation& Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences: 1st choice 'Recreation S Parks Board member type £RegcrPaP 2nd choice(optionall iplease select a board member type please select. 3rd choice (op8ional) ,please select a beard member type !please select If Veterans Advisory Commission list Branch of Military Service or Oraanixaticon What personal qualifications do you possess(i.e.,profession, previous experience,branch of military service or organization)which you feel would make you a good candidate for this board? Please be specific. Considerable experience with Parks, Marines, regulations, incorporation, Rails to Trails program in Marathon, First Choice: Florida.Was Chairman of the Near Shore Waters Committee when I moved to Boynton in 2004. See attached Curriculum Vitae extract. Second Choice:'. J i I 11 r i Third Choice: Feel free to attach an extra sheet or resume. Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard,City Hall,Mailing address: P.O. Box 310, Boynton Beach, FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank,a file to which Commissioners may tum for candidates when board openings occur. f hereby certify that the statements and answers provided herein are true and accurate. I understand that,if appointed,any false statements may be cause for removal from a board. Signature: ! �.0 C/`'- �/.� —. Date: Page 2 off z� Charles E. Kanter:Curriculum vitae EXTRACT Prepared for Boynton Beach City Commissioners, 18 October 2012 RE: Re-appointment to Recreation and Parks Advisory Board. 1. Cub Scouts- Den Leader, Pack leader. 1 Boy Scouts-Star, Life,Assist.Scout Master. Explorer. 3. US Naval Reserve-Honorable Discharge. 4. US Army-Infantry Training Cadre,HITC.Three awards. S. School Bus Driver-Ellenville NY 6. Agriculture, Licensed Real Estate sales,Community activist, Ellenville,NY 7. BA-Suny New Paltz,Post grad at Columbia,Executive Instructor Training,William&Mary 8. Director of Training-US Army Transportation School, Ft. Eustis Contract of Westinghouse LC 9. Director Community Action Program, Manchester,NH.Westinghouse Learning Corp contract. 10. Westinghouse LC Representative with Ohio State University and first Head Start Evaluation pro. 11. Director of Training for the JOBS program as loaned executive from Westinghouse Electric Corp. (Trained Loaned Executive frorn the 100 Cities identified by JOBS program "How to Hire Hard-Core Unemployed) 12. Director of Training for Federation Employment and Guidance Services,New York City 13.Commodore, Long Island Multihull Association. Founder,"Around Long island Race"produced first "in-the-water Sailboat show"on Long Island Sound. Founded Multihull Bermuda Race. 14.Amateur Radio Operator(HAM)Extra grade,call: K04WG 15. US Coast Guard 100 Ton Merchant Marine Officer License,with sail endorsement. 16. Worked with City of New York to create a usable park out of the WWII abandoned Floyd Benet Field on Jamaica Bay and use the seaplane launching ramp for our sailboats and the airstrips for our land- sailors. 17. Marathon, Florida-Incorporation Committee, Parks committee,rails-to-trails committee, Marina Committee,Chairman,. Near Shore Waters Committee;board member Marathon Sailing Club. 18. Monroe County Elections deputy. 19. Board member-Seven Seas Cruising Association. (SSCA) 20. Founded SAILco Press, 1987 Published first two books. (Marine,sailing,catamarans,cooking aboard) Parent Company of Sailco Marine Survey,SAMS AMS licensed and insured retired 12/201-0. 21. Made thirty-one(31)trips on the Intra-coastal waterway,multiple and numerous trips as Captain or owner through the Bahama chain and both windward and leeward island and greater Antilles including a 1998 month long excursion to Cuba under a treasury dept.License. 22. Moved to Boynton Beach 2004.Elected President, Parkside HOA 2005 23. Obtained Boynton Beach and Palm Beach County Occupational licenses. 24. Obtained Board Member Certification meeting requirements of:718.112(2)(d)(3).b.,F.5, 25.Applied and appointed to Recreation and Parks Board 2010. -rhis document is an extract.Additional information on any item stated can be documented,verified and expanded. Charles E. Kanter Date: 7 CITY OF BOYNTON BEACH LPrintForm , x" ADVISORY BOARD APPOINTMENT APPLICATION �' r Page 1 of 4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. Name r7� � 1• i(�sVr—iVi - Address City ' rcF.w State FL Zip Code Phone Number E-mail Address Current occupation or, if retired, prior occupation `s1 v � ;n Education t-s Are you a registered voter? (,Yes *?KNo t �� Do you reside within the Boynton Beach City limits? XYes ('No n �� n Do you own/manage a business within City limits? ('Yes �lo W rmc:) :::0-c If"yes", name of business: Are you currently serving on a City board? C Yes = os �No W 00 Have you served on a City board in the past? (-Yes (<No nD r rn n If so, which board(s)and when? Have you ever been convicted of a crime? (`Yes ')K No If so, when? F Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,see pages 3 and 4 below. Arts Commission @Education and Youth Advisory Board Planning& Development Board Building Board of Adjustment &Appeals Employees'Pension Board Police Officers' Retirement Trust Fund Cemetery Board Firefighters' Pension Trust Fund Recreation & Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences: 1 st choicerd... C member type please select... 2nd choice(optional) please select a board... member type Fplease select.. 3rd choice(optional) please select a board... member type please select... *If Veterans Advisory Commission, list Branch of Military Service or Organization: What personal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel would make you a good candidate for this board? Please be specific. First Choice: Second Choice: hird Choice: Feel free to attach an extra sheet or resume. Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall. Mailing address: P.O. Box 310, Boynton Beach, FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed, any false statements may be cause for removal from a board. Sig r1`ure: � i4 ` Date: ; , Page 2 of 4 10-18-12; 1 '1 : 1bAM; ;561-893-0650 # 2/ 3 CITY OF BOYNTON BEACH Print Form + � ADVISORY BOARD APPOINTMENT APPLICATION - Page 1 of Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. Name Address 42-10 city ,,1+,�� ,.�4t State FL Zip Codej3��i Phone Number E-mail Address (.oeykrwollp_ L Current occupation or, if retired,prior occupation r,,1 Education ,. / �n�v�rS��Y 01 � 5+6SO'l Uq;V4 S: Are you a registered voter? 0 Yes r No Do you reside within the Boynton Beach City limits? go Yes r No Do you own/manage a business within City limits? r Yes ®No If"yes", name of business: Are you currently serving on a City board? 4&Yes r No Have you served on a City board in the past? wyes C No If so, which board(s)and when? ,lave you ever been convicted of a crime? r Yes iiiii.No - If so,when? Where? You may serve on only one board. Please Indicate which advisory board(:)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board listing,re ulrements,responsibilities and meeting times and dates,see pa es 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning &Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers'Retirement Trust Fund Cemetery Board Firefighters'Pension Trust Fund Recreation&Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory commission" ry Board Preferences: 1 a nn:n -Q YC� aprrr yy G' cel 4 1 st choice please select a board.. ) membertype p/enase select.. 6OJ,t .vr� l�rinCG (L_ Jt+/� 2nd choice(optional) please select a board,,. member type please select... 3rd choice (optional) please select a board,,, member type please selecl... * 11 Veterans Advisory Commission,list Branch of Military service or Organization: 10-18-12; 11 : 16AM; ; 561-893-0650 # 3/ 3 What personal qualifications do you possess(i.e., profession, previous experience, branch of military service or organization)which you feel would make you a good candidate for this board? Please be specific. �, �.��. ��,�07�� s�� a � -rte `�lw•y,:.� ,� 7��.�b�g- w..JQ �i !04 5+ 44"e-1 OL-AJ V- cO&l s L e- 4 o.y o r-eS 7o First Choice: -tic � BJP. A �nK� Second Choice: Third Choice: Feel free to attach an extra sheet or resume. Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard,City Hall. Mailing address:P.O. Box 310,Boynton Beach,FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank,a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed,any false statements may be cause for removal from a board. Signature: Date: Page 2 of 4 CITY OF BOYNTON BEACH Print Form ADVISORY BOARD APPOINTMENT APPLICATION Pagel of 4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out'thisform. Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If.instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification.' Name Lvy- La iccia Address 1010 SW 17th STREET City BOYNTON BEACH' State FL Zip Code 33426 Phone lumber ;561 731 4317 E-mail Address n1tfff*@ JDK2398@JONO.COM Current occupation or, if retired, prior occupation EMMONIC TEC-1r7IC11M Education 11 grade, collinwood high, cleveland,ohio Are you a registered voter? (X yes r No Do you reside within the Boynton Beach City limits? offQs ,r No Do you own/manage a business within City limits? Xg&s (Ryo i If"yes", name of business: Are you currently,serving on a City board? {^Yes CXNo Have you served on a City board in the past? ^yes ANO i-0 If so, which board(s)and when? c> co Have you ever been convicted of a crime? {"Yes (K No c3 M> If so,when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times.and dates,see pages,3 and 4 below. ,Arts Commission Education and Youth Advisory Board Planning &Development Board Building Board of Adjustment&Appeals ` Employees' Pension Board Police Officers'Retirement'Trust Fund Cemetery Board Firefighters'Pension Trust Fund Recreation&-Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences: 1st choice please select a board... Senior Advisory Board member typeplease select... 2nd choice (optional) please select a board..Education & Youth Advisoitmber type please select... 3rd choice (optional) please select a board... member type please select... If Veterans Advisory Commission,list Branch of Military Service or Organization: Mat personal qualifications do you possess(i.e., profession, previous experience, branch of military service or organization)which you feel would make you a good candidate for this board?Please be specific.' COMPANY CLERK, US ARMY. OWNED AND OPERED A RETAIL SALES AND SERVICE ORGANIZATION FOR 7 years in OHIO (EUCLID) and FLORIDA (HOLEWOOD), BELONGED TO THE MIRAMAR CHURCH OF GOD, MIRAMR, FL. AND WASTHE FADER OF THE MENS FELLOWSHIP FOR ONE YEAR.BELONGED TO 7'HIIKMS First Choice: FULL GOSPEL HUSSNINESS MENS FELWWSHIP INTERNATIONAL,BELONGED TO THE MIRAMAR CHAMBER 06 COMMERCE, ASS. PASTOR OF SOLACE COVE MINISTRY OF BOYNTON,BEACH, A MEMBER OF THE SENIOR CITZENS CENTER. ' MARRIED, RAISED FOUR CHILDREN, HELP RAISE 10 grand children and two great grand children and I'm a (YOUNG', MAN) at eighty four years old. ; Second Choice hird Choice: Feel free to attach an extra sheet or resume.Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall. Mailing address: P.O. Box 310, Boynton Beach, FL 33425-0310 FAX to: (561),742-6090 it will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed,any false statements may be cause for removal from a board. Signature ' Dateejq J ' Page 2 of 4 CITY OF BOYNTON BEACH Print Form C, ADVISORY BOARD APPOINTMENT APPLICATION Pagel of 4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is;expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification.' Name ' uro` 1,,1.xn CA �La's Address S Ulff�4n 'rrao( ,' , i City StateFL Zip Code Phone rvumber, q,37 -6 4"7. 6 E-mail Address C.car6 t t.h�'. Current occupation or, if retired,prior occupation t 1 n G i-pot 1 Education i n 2 I A I t/e1,5 Are you a registered voter? C Yes ;f^No :7 Do you reside within the Boynton Beach City limits? ( Yes (-No . c Do you own/manage a business within City limits? C Yes ONo n, If"yes", name of business; Are you currently serving on a City board? A Yes ( No cnQ Have you served on a City board in the past? *Yes ( No If so,which board(s)and when? CA lir� N ) b; V( 15 o r C� Have you ever been convicted of a crime? r Yes N If so,when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,see pages 3 and 4 below. Arts Commission Education and Youth'Advisory Board Planning &Development Board Building Board of Adjustment&Appeals Employees' Pension Board Police Officers' Retirement Trust Fund Cemetery Board Firefighters'Pension Trust Fund Recreation &Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences: 1 st choice please select a board... tt.C' * .; M v,,5 ov � member type please select. �Q. iler'� + 2nd choice (optional) please select a board... member type please select.. 3rd choice (optional) please select a board... member type please select.. *If Veterans Advisory Commission,list Branch of Military Service or Organization: What personal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel would make yoiu a good candidate for this board? Please be specific. I a d . > 1 1 ✓rj an c�ler�t-elt, First Choice; (( _1- ��Iun1n I 'str4+or 4;j V ty pt je r fa VL ef,5 to l a lea gym " he e Second Choice 9'hird Choice: Feel free to attach an extra sheet or resume.Return the completed form to: City Clerk's Office, 1MEast Boynton Beach Boulevard, City Hall. Mailing address:P.O. Box 310, Boynton Beach, FL 33425-0310 FAX to: (561)142-6080 It will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. I hereby certify,that the statements and answers provided herein are true and accurate. l understand that, if appointed, any false statements may be cause for removal from a board. Signature: Date: Page 2 of 4 a, CITY OF BOYNTON BEACH PdntForm ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be ret"urned for clarification. Name e rC x1 t /1C, Address 311 City A/7 "ale �( State FL zip Code ��3PhoneNumber7 7 0 E-mail Address Current occupation or, if retired, prior occupation Education Are you a registered voter? (Yes '("No Do you reside within the Boynton Beach City limits? XYes No Do you own/manage a business within City limits? Yes No If"yes' name of business: CD " Are you currently serving on a City board? XYes ('No , Have you served on a City board in the past? r*aM '5<'yes *No ors n If so,which board(s) and when? LO Al r 0 5 e !' Have you ever been convicted of a crime? (—Yes (RNo if so when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,seepages 3 and 4 below. Arts Commission Education and Youth AdvisoryBoard Planning &Development Board Building Board of Adjustment&Appeals Employees' Pension Board Police Officers' Retirement Trust Fund Cemetery Board Firefighters'Pension Trust Fund Recreation& Parks Board Code Compliance Board Golf Course Advisory Committee Sen dvisory Boal Community relations Board Library Board Veterans Advisory Commission* Board Preferences: 1 st choice please select a board... �`�1L/' j.. � ,member type please select... 2nd choice (optional) please select a board... member type please select ;rd choice (optional) please select a board... member type please select.. "If Veterans Advisory Commission, list Branch of Military Service or Organization: What personal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel would make you a good candidate for this board?Please be specific.�-�.,�'" First Choice: G Second Choice, "hird Choice:! Feel free to attach an extra sheet or resume. Return the completed form to: City Clerk's Office, 100.Fast Boynton Beach Boulevard, City Hall. Mailing address: P.Q. Box 310, Boynton Beach,FL 33425-0310 FAX to: (561)742--6090 It will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed,any false statements may be cause for removal from a board, Signature: Dater Page 2 of 4 CITY OF BOYNTON BEACH printForm ' ADVISORY BOARD APPOINTMENT APPLICATION page 1 of Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. if instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. .Name Address 2-37 City Fe � -�� State FL Zip Code '3314-35 Phone Number ,�_ ,.-��+�• E-mail Address M T'G. Current occupation or, if retired, prior occupation �5"F'.�-T'v ` '�'' �, - 1&y<+-T& Education Are you a registered voter? Yes C No Do you reside within the Boynton Beach City limits?XYes No Do you ownlmanage a business within City limits? (-Yes XJNQ If"yes" name of business: Are you,currently serving on a City board? XYes (' Norq Have you served on a City board in the past? )<Yes f No <4 l If so,which board(s) and when? Nave you ever been convicted of a crime? t^Yes > No If so,when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,seepages 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning &Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers'Retirement"Trust Fund Cemetery Board Firefighters' Pension Trust Fund Recreation &Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences: 1 st choice please select a board.. member typepleas select... 2nd choice(optional) please select a board... member type please select... 3rd choice (optional) please select a board... member type please select... *If Veterans Advisory Commission,'list Branch of Military Service or Organization: What personal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel would make you a good candidate for this board? Please be specific. First Choice: r — ,. Feel free to attach an extra sheet or resume. Return the completedform to: City Clerk's Office, 100 East Boynton.Beach Boulevard, City Hall.'Mailing address: P.O. Box 310, Boynton Beach, FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank,a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand'that, if appointed,any false statements may be cause for removal from a board. Signature: (?r)-te Date: D — — 0 ur Page 2 of 4 Cathleen V. McDeavitt 237 SIA/ 9"' Avenue Boynton Beach, FL 33435 561-734-7244 (Home) 561-715-3107 (Cell) mtek(d-, -n bellsouthet . . . .. . ....... ........ Occupation Summarv: Manager with over 30 years of public sector experience. Managed departmental budgets between $2M - $9M. Coordinated staff and resources for various technology projects, special events and organization-wide initiatives. Leader in.managing cross functional.team efforts through effective and motivating strategies. Educafion/Trainin.,L� Duffs Business School, Pittsburgh, PA., Courtroom Reporting - 1977 Florida Institute of Government-PaIrn Beach Community College 2000 Certified Public Pension Trustee-2004 - 2012 Leadership Boynton Beach-Class of 2006 Accomplishments Serve as department representative to the Grant Team. Successfull-, obtained grant funds from: • Workforce Alliance in the amount of$21,600 for the Employed Worker Training Program. • Division of Emergency Management in the arnount of$37,260 to expand an AM Radio system. • Lattner Foundation in the amount of$48,900 for the community senior center. Reduced department budget by $9,000 annually through implementation of networked copiers/printers. Served as an employee representative to the General Employee Pension Board from 1998 through 2009; and as a citizen appointed by the City Commission from 2010 to current. Plan enhancements during my tenure include 5 year vesting; Deferred Retirement Option Pro-ram.(DROP): and a pre-retirement death benefit. Co-creator of the City Services Institute-This program was developed to acquaint residents and business owners with the structure of local goven-flnent; and, to provide them with information and tours in an entertaining and informative manner that enabled there to become more fully involved in their community. Presented a city-wide cell phone policy for adoption. All departments were positively impacted. My department realized a cost savings of$6000 via the estabtisl-u-nent and implementation of this policy. Acconip,lishrrients �cont.'d� - Chaired.the Values Committee. The purpose of this committee was to integrate the values of Diversity, Integrity, Stewardship and Creativity into the daily functions of the workplace. Staff was recognized on a nnonthl.y basis for exhibiting the values. An annual employee picnic was incorporated to generate interest and incorporate the values through fun, comradely, and team spirit. Achieved a perfect safety record. v Functioned as co-director for the Information Technology Services Department for 9 months. Served on the recruitment and selection committee to secure a permanent director for this department. Ern��1Qyment Experience I have been employed by the City of Boynton Beach for the past 30 years in various capacities. Below is my history with this organization. 1999—Current Infonnation Technology Services Dept. —Assistant to the Director Responsibilities: Manage daily activities and work assignments of a 3 member information technology help desk team who provide technical support to 600 computer users, insuring Service Level Agreements were met 98% of the time. Manage daily activities and work assigmi7ent for the City of Boynton. Beach's webmaster. This position was responsible for the design., content management and electronic applications of the city's website. Manage daily activities and work assignments for the City of Boynton Beach.Video Production Specialist. Tliis position was responsible for the programming of the city's public education government television channel. Conduct semi-annual and annual performance evaluations. Contract Management—Insure that all software and hardware maintenance contracts were current; negotiate multi year contracts with various vendors for cost savings advantages. Budget—Collaborate with senior staff members to prepare and present an annual budget between$2M - $6M to City Commission for approval. Prepare purchase orders for director's approval. Insure procurement policy was followed for all purchases. Accountable for monthly budget reconciliation. 1990- 1999 Parks &Recreation Department—Administrative Assistant II Responsibilities: Prepared weekly payroll for 35 full time and 35-46 part time/seasonal staff members. Prepared quarterly grant reports for County, State and Federal funding obligations. Managed the daily activities and work assignments of 5 clerical staff. Conducted annual staff evaluations. Incorporated an electronic program registration system. Recorded and transcribed all of the Director's correspondence. Prepared monthly board minutes. Provided administrative assistance to event coordinators. Initiated and coordinated a green market in downtmvii Boynton Beach. Prepared media releases. Prepared bid documents. Prepared documents for. City Commission approval. Maintained department files. Accountable for monthly budget reconciliation. Insured procurement policy was followed for all purchase. Collaborated with senior staff members to prepare an annual budget of $5M to City Commission for approval. 1982— 1990 Utilities Administration—Administrative Assistant I Responsibilities: Prepared weekly payroll. Prepared monthly, quarterly and annual reports for State and Federal compliance. Prepared bid documents. Prepared documents for City Commission approval. Maintained as-built drawings and development plans. Recorded.and transcribed all of the Director's correspondence. Accountable for monthly budget reconciliation. Insured procurement policy was followed for al.l.purchases. Supervised clerical staff. Conducted annual staff evaluations. Collaborated with senior staff members to prepare an annual budget of$9M. 1980- 1982 Public Works Department—Clerk 11 Responsibilities: Prepared weekly payroll. Prepared monthly, quarterly and annual reports. Scheduled & coordinated service to all city vehicles. Procurement of fuel for city-wide use. Dispatched vehicles for service calls. References: Available upon request CITY OF BOYNTON BEACH Print Form ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board,selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. Name Address City j State FL Zip Code "Phone Number E-mail Address Current occupation or, if retired, prior occupation a � Education Are you a registered voter? des ( No Do you reside within the Boynton Beach City limits? (b'�es No Do you own/manage a business within City limits? yes A If"yes" name of business: c� Are you currently serving on a City board? yes (P-<0 ' Haveyou served on a City board in the past'? yes s"Nocn XZ If so, which board(s)and when? Cf e) V , riave you ever been convicted of a crime? (^yes Ln If so, when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Priorltize up to three choices'with number 1'being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,seepages 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning & Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers' Retirement Trust Fund Cemetery Board Firefighters'Pension Trust Fuad Recreation &Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Boar Prefer en n d e c+es. 1 st choice please select a board... member type please select,.. 2nd choice (optional) please select'a hoard... member type please select... rd choice (optional) please select a board... member type please select... *If Veterans Advisory Commission, list Branch of Military Service or,Organization: What personal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel would make you a good candidate for this board? Please be specific. First Choice: Second Choice; ,'hird Choice: Feel free to attach an extra sheet or resume. Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hail. Mailing address:P.O. Box 310, Boynton Beach, FL 33425-0310 FAX'to: (561)742-6090 It will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed,any false statements may be cause for removal from a board, Signature: ,/ ©ate: /61_ 1 Page 2 of 4 CITY OF BOYNTON BEACH Print Form ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly, If interest is expressed in appointment to`rnore than one board, selections must be "moritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned`for clarification, Name AddressN IV- W• * ' City State L Zip Code :Phone Number - E-mail Address f 5 ( , 0('0 1 rJ Current occupation or, if retired, prior occupation CU Q,6 (' EducationJ� , Are you a registered voter? *,Yes `^No Do you reside within the Boynton Beach'City limits? Mes No Do you own/manage a business within City limits? Yes if"yes",.name of,business-F Are you,currently serving on a City board? Yes No Have you served on 6City board in the past? Yes ^No _ ' d If so, which board(s)and when? ( Y1 Ur Q � UYti b 1n.S i6 0V� nave you ever been convicted of,a crime? Yes', d5(No If so,when? F Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference,Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,see pages 3 and 4 below. Arts Commission Education and Youth;Advisory Board Planning & Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers'Retirement Trust Fund Cemetery Board Firefighters'Pension Trust Fund Recreation& Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences: 1 st choice please select aboard.. torn m V. T�t � � �= 0. C ri5 member type please select...(" 2nd choice(optional) 1please,select a b arrd... member type please select... 3rd choice(optional) please select a-board.., member type please select... ` If Veterans Advisory Commission,list Branch of Military Service or Organization: What personal qualifications do you possess(i.e. profession, previous experience, branch of military service or organization)which you feel would make you a good candidate for this board? Please be specific. First Choice: Second Choice bird Choice: Feet free to attach an-extra sheet or resume.Retum the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall Mailing address: P.O. Box 310, Boynton Beach, FL 33425-0310 FAX to; (561)742-6090 It will be,placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. 1 hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed,any false statements may because for removal from a board. Signature: BUJ Date: 1 . 62, /Aj Page 2 of 4 CITY OF BOYNTON BEACH' Print Form 0 - ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board', selections must be prioritized. If instructions are not followed or the a' ' ation is not filled out in its entirety, the form will be returned for clarification. Marne '-- Address 0C) City State FL Zip Code Phone Number. fq/-W E-mail Addresses Current occupation or,_if retired, prior occupation Education Are you a registered voter? fi�4YeS(" No Do you reside within the Boynton Beach City limits? Eyes (-No Dv you own/manage a business within City limits? r yeS o � a ry s� If"yes" name of business: CD � -7 Are you currently serving on a City board? es No 1`10 Have you served on a'City board in the past? (^Yes Flo If so,which board(s)and when? Have you ever been convicted of a crime? ('yesNo r- ! co r If so,when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three'choices with number 1 being the most.desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,see;pa es 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning & Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers'Retirement Trust Fund Cemetery Board Firefighters' Pension Trust Fund Recreation&Parks Board Code Compliance Board Golf Course Advisory Committee " Senior Advisory Board Community Relations Board Library BoardVeterans Advisory Commission* _® hoard Teferences: ------------ 1 st choice please select a board.. member type plea�� 2nd choice (optional) please select a board... member type Ip/ease so . 3rd choice(optional) please select a board... member type please select... " If Veterans Advisory Commission, list Branch of Military Service or Organization: . What personal qualifications do you possess (i.e., profession,previous`exoeriencg,branch of military seTvJce or organization)which you feel would make you;a good candidate for this board? Please be specific. First Choice: s _ , Second Choice Third Choice: -Feel free to attach an extra sheet or resume.Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard,City Hall. Mailing address: P.Q. Box 310, Boynton Beach, FL 33425-0310 FAX to, (561)742-6090 It will be placed in the City's Talent Bank,a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. 1 understand that, if appointed, any false statements may be cause for removal from a board. r Signature: , � Date: Oaf, 010't"?v Page 2 of 4 CITY OF BOYNTON BEACHPrint Form ADVISORY BOARD APPOINTMENT APPLICATION Page 1 aft Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers'clearly. If interest is lexpressed in appointment to more than one board, selections must be prioritized. If instructions are not followed ` the application is not filled out in its entirety, the form will be returned for clarification. Name - Address City State FL Zip Code Phone Number / -mail Address V Lt---f TRA Dy (a—)— , Current occupation or, if retired, prior occupation 77 Education Are you a registered voter? es r No Do you reside within the Boynton`Beach City limitses ,r No Do you own/manage a.business within City limits? C Yes j"o If"yes'; name of business: +P Are you currently serving on a City board? es f^No w Have you served on a City board in the past? es f No If so,which board(s)and when?FAX nave you ever been convicted of a crime? C YesPTO '� If so,when? „ Where? You may serve on only one board. Please indicate which advisory boards)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least Pref or board listing,requirements,responsibilities and meeting times and dates,see pa es land 4 below, Arts Commission Education and Youth Advisory Board Planning & Development Board Building oard fo Adjustment&Appeals Employees'Pension Board Police Officers'Retirement Trust Fund Cemetery Board Firefighters' Pension Trust Fund Recreation &Parks Board Code Compliance Board Golf Course AdvisoryCommittee ,Senior Advisory Board Community Relations Board' Library Board Veterans Advisory Commission* Board Preferences: 1 st choice please select a board... � member type please se r,,_Q 2nd choice(optional) ,please select a board... member type please select rd choice (optional) please'select a board.,. member type please select... *If Veterans Advisory Commission,list Branch of Military Service or Organization: What personal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel would makeyou a:good candidate for this board? Please be specific. - '� First Choice: Second Choice nird Choice: Feel free to attach an extra sheet or resume. Return the completed form to City Clerk's Office, 100 Bast Boynton Beach Boulevard, City Hall.Mailing address: P.O. Box 310, Boynton Beach, FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed,any false statements may be cause for removal from a board. Signature: Date: 10 /D-7 /I r�— Page 2 of 4 c t. 29. 2012 10;29AM CITY OF BOYNTON BEACH No, 3940 P. .2�tForm 3 ADVISORY BOARD APPOINTMENT APPUCATION Page 1 of 4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed In appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification, Name Roger G. Saberson Address 27411 SW 23rd Cranbrook Dr. City Boynton Beach Stale Fi_ zip Code ' 33436 Phone Number (561) --2728616 E-mail Address saroger@att.net Current occupation or, if retired, prior occupation Attorney Education Juris Doctor-University of Illinois Law School Are you a registered voter? G,11(es (-No Do you reside within the Boynton Beach City limits? (Oes r No Do you own/manage a business within City limits? r Yes (4o If"yes",name of business: Are you currently serving on a City board? Des r No Have you served on a City board in the past? toes rNo If so,which bo.ard(s)andwhen?l planning and Development Board 4ave you ever been convicted of a crime? (,yes If so,when? Where? YOU may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board list!n ,re uirements,res onsibllitles and meeting t)mes and dates,see a es 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning &Development Board Building board of Adjustment&Appeals Employees'Pension Board Police Officers'Retirement'Trust Fund Cemetery Board Firefighters'Pension Trust Fund Recreation &Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission' Board Preferences: let choice please select aboard..planning & Development Bd membertype please select.. Regular 2nd choice(optional) please select a board... member type .please select.. 3rd choice(optional) please select s board... member type please select..�® If Veterans Advisory Commission,list Branch of Military Service or'organization: vv►0 c t. 2 9. 2012...10:3 0 AM'o you possess ti.e,, procession,previous experience,orancn or mmrarN o. 3 9 4 0 or o p, 3tation)wrncn you reei wouio make you a good candidate for(his board?Please be specific. I have served as a Regular Member of the Planning and Development for several years. z am an attorney and have substantial experience in municipal law and planning law. I have previously served as City Attorney of Delray Beach and I am currently General Counsel -First Choice: of the Treasure Coast Regional Planning Council who I have represented for over 25 years, Second Choice Third Choice: Feel free to attach an extra sheet or resume. Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard,City Hall. Mailing address: P.O. Sox 310, Boynton Beach,FL 33425-0310 FAX to:(561)742-6090 It will be placed in the City's Talent Bank,a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed,any false statements may be cause for removal from a board. 'signature: Date: /4� Page 2 of ?_0/25/2012 6_24PM FAX X0002/0003 CITY OF BOYNTON BEACH RFitit;Forin ' ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of 4 Thank you for your'interest In serving on a City advisory board and for taking the time to fail out this form, Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized:,If'iiistructions.are•not followed or the,application is not.filled out in its entirety,the form will be returned for clarification. Name ' e i'Z Address b �GiDH- - City , �.� n° Q d_ State FI, zip Code phone Number E-mall Address (V'. - e�114 [ .�0! ,C.t Current occupation or, If retired, prior occupation N , ✓�{ Education•• ��.��a-r ._ ... ry w.rw.. ..•�, rR".Y,.' r —'••'.w�""Ywrdw`w,RMr.--rn�.� .�.6 l /.9.i Are you a registered voter? NYes C'No Do you reside within the Boynton'Seach City limits? Zf yes r No Do you own/manage a business within City limits?, (`Yes No If"yes", name of business; Are,you.currently serving on.a City board? (4es r No Have you served on a City board In the past? 'ies (-No If'so,which board(s).and when?' ,eve you ever been convicted of a crime? r Yes Z�No If so,when? Where? You may serve on,only one board, Please Indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three-choices with number 1 being the most desired and 3 being the least referable,For board listing,re ulrements,res Eon3lbilities and meeting times and dates,see pa2es 3 and A below. Arts Commission: Education,and Youth,Advisory Board Planning•&•De'velop'ment Board Building Board of Adjustment&Appeals Employees'Pension Board Police O ra'Rtirement'Trust,Fund " "-CarrrneYry-Bca,rd' - -.—Firefighters'•PensiorrTrost-Fund � REcreatierrr& - Code Compliance Board' Golf Course Advisory Committee Senior Advisory Board Cammunity'Relations Board Library Board Veterans Advisory Commission* Board Preferences: 1st choke please select,a board.... �� C member type please select..: 2nd choice(optional) 1please select a board.., member type please select,. 3rd choice(optional) please select a board.., + member type please select... "If.Veterans Advisory Commisslon,list Branch of Military Service or Organization: 1 U/'Ly/1V 1'L b:Z4VM FAX IM 000.3/0003 What personal qualifications do you possess(i.e:,-profession, previous experience, branch of military service or organization)which you feel would mai yo'u;a;�good candidate for this board? Please be specific. First Choice: . � �• �al'��,�►9 cam,, ` ��► d`�a�� 8�r� Second Choice: 'hlyd Choice: Feel free to attach an extra sheet or resume.Return'the completed form,to: .''" • r-71`CirytIbrR'g1ZTfffice;T00 as�oynt n ach�ou"ievar'�c pity Hall' ai ing ad6rQs P ffOx—, iBoj►nton°Beach,FL*3.3425=1)310 ' FAX to:(561)742-6090 It will be placed in-the.City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed,any false statements may be cause for removal from a board. -Signature- 'bate: Page 2 of 4 CITY OF BOYNTON BEACH Print Form ADVISORY BOARD APPOINTMENT APPLICATION page 1 of 4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety, the form will be returned for clarification. Name Jeannie Dee Taylor Address 12121 SW 15th Avenue K1 02 City Boynton Beach State FL Zip Code 33426 Phone Number (561)736-6435 E-mail Address jeannied@bellsou#h.net Current occupation or, if retired,prior occupation Transit Planner Education Library Science Masters Are you a registered voter? (:Yes ( No Do you reside within the Boynton Beach City limits? (:Yes C No Do you own/manage a business within City limits? ( Yes (:No If"yes", name of business: Are you currently serving on a City board? (:Yes f"`No Have you served on a City board in the past? G Yes ('No If so,which board(s)and when?Library Board currently, Charter Review board Have you ever been convicted of a crime? C Yes (*—No If so,when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board Fisting,requirements,responsibilities and meeting times and dates,see pages 3 and 4 below. j Arts Commission Education and Youth Advisory Board Planning& Development Board Building Board o€Adjustment&Appeals Employees'Pension Board Police Officers' Retirement Trust Fund Cemetery Board Firefighters' Pension Trust Fund Recreation & Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences: 1 st choice !Library Board member type Regular 2nd choice (optional) (please select a board... member type please select... 3rd choice (optional) [pease seoarllect a bd... type P member t 1 lease select.. , *if Veterans Advisory Commission, list Branch of Military Service or Organization: a , What personal qualifications do you possess(i.e.,profession, previous experience, branch of military service or organization)which you feel would make you a good candidate for this board?Please be specific. First Choice: currently serving as Chair of the Library Board Second Choice- Third Choice: Feel free to attach an extra sheet or resume. Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Nall. Mailing address: P.O. Box 310, Boynton Beach, FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank,a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate.I understand that, if appointed, any false statements may be cause for removal from a board. I I Signature: Date: Page 2 of 4 CITY OF g0YNTO ADVISORY BOARD APPOINTMENTN BEACH Thank YOU for 'APPLICATION Print Form Please print or#Ype Your interest in serving on a City advisory board and for talon the Page 1 of4 y. If interest is expressed in a not followed or the application is not filled out in ent to 9 time to fill out this form, Name �-- more than one boar entirety, theform wJ1J selections must be be returnetl for clarification. Address City E-mail Address State FL Zip Code i343- ' J �„c Phone MemberP / 7,9 —f Current occupation or, t'fretired, prior 0ccupation4A i Education � Are you aregistered voter? __// Do you reside within the 61yes r No e Boynton Beach City limits? Do you own/manage a business within City limt es t''No its? (-Yes i,VNo if"yes", name of business: Are you currently serving on on a City board? Have you served on a City board in th yes r"'No o e Past? (VY, ' -�- if so, which boards s ('No ( )and when? ,Have you ever been convicted of a crime? Yes MIN, 1 7- If so,when? You may serve on only one board. Pie ase Indicate w Where? {'> C- as a regular member,alternate,or no preference,Prioritize u preferable;For board listing,r which advisory board{s)you are seekinto three ch a equirements,responsibilities and meet ng toices with imes and number appointment AND whether Arts Commission being the most desired and 3 bein dates,see pages 3 and 4 below. g the least Buildin Education and Youth Advisory 9 Board of Adjustment&Appeals Em Employees, rY Board cemeteryP yees,Pension Board 'tanning& Development Board Board Code Compliance Board Firefighters'Pension Trust Fund Police Officers'R et►rernent'Trust Fund Community Relations Board rY Comrnittrre Golf Course Advisory Recreation&Parks Board Library Board Senior Advisory Board Veterans Advisory Commission* Board Preferences: 1st choice please select a board.. , 2nd Choice(optional) member type please select., P/ease select a board., Mrd choice o member type please select.,, ( phonal) P1 select a board!. "If Veterans Advisorymember type Please select- list Commission, list Branch of Military Service or Organization: What personal,qualifications do you possess (i.e.,profession, previous experience, branch of military service or organization)which you feel would'make you a good candidate for this board?Please be specific. First Choice: Second Choice; hird Choice: Feel free to attach an extra sheet or resume.Return the completed form to: City Clerk's Office, 100 Fast Boynton Beach Boulevard, City Mall. Mailing address: P,O.. Box 310, Boynton.Beach, FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate.i understand that, if appointed,any false statements may be cause for removal from a board. Signature: Date. /G Si 9 y Page 2 of 4 2012 1 :34PM No. 1095 P. 1 CITY OF BOYNTON BEACH Print Form Gi 0 ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. _X /r - Name G � 1 Address � � p — -- - City �✓ StaIeFZIp Code Phone Number E-mail Address i{n i�'1 � t �- Current occupation or,if retired, prior occupation Education wt_�7j� Are you a registered voter? ISYes (-No Do you reside within the Boynton Beach City limits? *yes (-No Do you own/manage a business within City limits? ( Yes oNo if"yes", name of business; Are you currently serving on a City board? 46 Yes ('No Have you served on a City board in the past? ryes ( No If so,which board(s)and when? Have you ever been convicted of a crime? (-Yes No If so,when? � A Where? nJ A You may serve on only one board. Please Indicate which advisdry board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 7 being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meetino times and dates,see pages 3 and 4 below. its Commission Education and Youth Advisory Board Planning r1, Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers'Retirement Trust Fund Cemetery Board Firefighters'Pension Trust Fund Recreation &Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences: 1 st choice please select a board... fl) rt-.-S12wYn member type please se/eCt,., 2nd choice(optional) please select a board... member type please select... r 3rd choice(optional) please select a board... member type please select... *If Veterans Advisory Commission,list Branch of Military Service or Organization: Oct. 29. 2012 1 :34PM No, 1095 P. 2 What personal qualifications do you possess(i.e., profession,previous experience,branch of military service or organization)which you feel would make you a good candidate for this board?Please be specific. /fl0 cc�UU(�e,� `ae- 4?- First Choice: Second Choice Third Choice: Feel free to attach an extra sheet or resume. Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard,City Hall.Mailing address: P.O.Box 310, Boyhton Beach, FL 33425-0310 FAX to:(561)742-6090 It will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. 1 hereby certify that the statements and answers provided herein are true and accurate.I understand that, if appointed,any false statements may be cause for removal from a board. Signature: Date: f Page 2 of CITY OF BOYNTON BEACH Print Form ADVISORY BOARD APPOINTMENT APPLICATION Page t of Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. .Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. Name fA Sip+.T Address ( 4 AUS, City nac_h State Phone NumbeZi Code 5t 72`- $'703 E-mail Address; Current occupation or, if retired,prior occupation Education Are you o registered voter? A yes No <D Do you reside within the Boynton Beach City,limits? Yes r No "4 r7l,1 o Do you;own/manage a business within City limits? C yep P,No If"yes", name of business: c� Are you currently serving on a City board? wyes �^No 4M, ar Have you served on aCity board in the past? 0 yes f^No t-');, 1f so, which board(s) and when? PPcam. f ? LePA n Have you ever been convicted of a crime? Yes &No If so,when? Where? You may sere on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,see pages 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning &Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers'Retirement Trust Fund Cemetery Board Firefighters'Pension'Trust Fund Recreation & Parks Board Code Compliance Board Golf Course Advisory;Committee Senior Advisory Board Community Relations Board Library Board Oeterans Advisory Commission* 0 Board Preferences: 1 st choice please select a board,.. member type please select,.. 2nd choice (optional) please select a board... member type please select... Jrd choice(optional)' please select board... membertyp e ; please select... "If Veterans Advisory Commission, list Branch of Military Service or Organization: What personal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel would make you a good candidate for this board? Please be specific. First Choice: Second Choice. hird Choice: Feel free to attach an extra sheet or resume.Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall. Mailing address: P.O. Box 310, Boynton Beach, FL 33425-0310 FAX to:(561)742-6090 It will bp=placed in the City's Talent Bank, a file to which'Commissioners may turn for candidates when board openings occur. I hefa j o i hatAhe statements and answers provided`herein'are true and accurate. I understand that, if appointed,any false statements may be cause,for removal from a board. r Signature: Date. �0^ ? Page 2 of 4 CITY OF BOYNTON BEACH print Form ADVISORY BOARD APPOINTMENT APPLICATION .Page 1 of 4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. :Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification.' Name. Address CA�A " City Q >rl i State FL Zip Codec 'Phone Number 1 . -maiLAddress 4 } Current occupation o'r, if retired, prier occupation -� " ° Education 1 Are you a registered voter? 116yes C No Do You reside wiithin the Boynton'Beach City limits? yes No Do you own/manage a business within City limits?', ^Yes go No If"yes"; name of business: [ Are you currently serving on a City board? 4 Yes C No ry Have you served on a City board in the past? r Yes A No _< If so,which board(s)and when? 1- a ti J - 2 o0 Have you ever been convicted of a crime? Yes No CD 1f so,when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1;being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,.see;pages 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning &Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers'Retirement Trust Fund Cemetery Board Firefighters'Pension Trust Fund Recreation & ParksBoard Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission* Board Preferences: 1st choice please select a board... 00kpr" member type pleasetsplect. 2nd choice (optional) please select a board... member type please selects.. 3rd choice(optional) please select a board... member type please select... *If Veterans Advisory Commission,list Branch of Military Service or Organization; ---• What personal qualifications do you possess (i.e, profession, previous experience, branch of military service or organization)which you feel would make you agood candidate for this board? Please be specific. First Choice:' C!1 C t " a►n 61 Second Choice iNhird Choice: Feel free to attach an extra sheet or resume.Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall'mailing address; P.O. Box 310, Boynton Beach,F1L 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank, a file to which'Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed,any false statements may be cause for removal from a board. y Signature:9ILA, Date: � 0 Page 2 of 4 FROM H Ix E WOLF UTC TIME PHONE NO. : 5619666351 Nov. 14 2012 05:24PM P2 CITY OF BOYNTONEAC ADVISORY BOARD APPOINTMIFNT APPLICATION Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety, the form will be returned for clarification. Name Halena Wolf Telephone # 561966-6350 Address 3619 Providence Road, Boynton Beach, FL 33436 Current occupation: Art Educator Education: B.A. Psychology, St. Joseph University, Graduate Studies: Rhode Island School of Design Are you a registered voter?_x Yes No Do you reside within the Boynton Beach City limits? _x_ Yes—No. Do you own/manage a business within the City limits: Yes_x No If"yes", name of business _ Are you currently serving on a City board? Yes—x —No Have ypu served on a City board in the past? _x Yes No If so, which board(s) and when? Public Art Have you ever been convicted of a crime? NO If so, when where Please indicate (by number) to which advisory board(s) you are seeking appointment. You may serve on only one board. Please do not check more than three boards. Prioritize your choices by number, 1 being the most desired and 3 being the least preferable. For board requirements, responsibilities and meeting times and dates, see the attached listing. . Advisory Board on Children &Youth -Employees' Pension Board _x Arts Commission „Firefighters' Pension Trust Fund Building Board of Adjustment & Appeals Golf Course Advisory Committee Cemetery Board ,_Library Board Code Compliance Board Planning & Development Board Community Redevelopment Agency* Police Officers' Retirement Trust Fund _Community Relations Board ---Recreation & Parks Board education Advisory Board Senior Advisory Board Resume required What personal qualifications do you possess (i.e., profession, previous experience) which you feel would make you a good candidate for this board? Please be specific. Working public artist, Art Educator/ Department Chair for Palm Beach County School District LZ :S Nd I I AON Z1 301J;0 S.A8310 ),Ila N3V38 N01.NA09 30 Alit, FROM H & S klOLF UTC TIME PHONE NO. : 5619666351 Nov. 14 2012 05:24PM P3 First Choice: Public Art Commission Feel free to attach an extra sheet or resume. Return the completed form to the City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall. Mailing address: P. 0. Box 310, Boynton Beach, FL 33425.0310. It will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. I hereby certify Oat- " stat ents and answers provided herein are true and accurate. I understand tifa t,if,a `lnte any false statements may be cause for removal from bo rd, Signature- Date:_ f .. jrnp 4/27/06 11:55 AM j:lshrdat2\cc\wplboards\appmentsfraster form-talent bank form.doc CITY OF BOYNTON BEACH Print Form ADVISORY BOARD APPOINTMENT APPLICATION Page 1 of 4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form. Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. Name RoseMarie yerzy (Mrs.) Address 26 Hastings Lane City Boynton Beach State FL Zip Code' 33426 Phone Number 23 9996 E-mail Address rmyinboynton@aol.com Current occupation or, if retired,prior occupation Office Manager - Howard J. Miller, P. E. ;inc. (23 Years) Education I High School, Some ,College, 23 years working at: my present position in the Are you a registered voter? 'Yes (—No Courses; Structural Engineering ]Field Do you reside within the Boynton Beach City limits? 0,yes r No Do you own/manage a business within City limits? (-Yes &No 1#"yes" name of business: Are you currently serving on a City board? AF Yes No Have you served on a City board in the past? 0Yes f No If so,which board(s) and when? Code Compliance Board, Present Member (Permanent Member) Have you ever been convicted of a crime? C Yes; No if so,when? Where? You may serve on only one board. Please indicate which advisory board(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,seepages 3 and 4 below. Arts Commission Education and Youth Advisory Board Planning &Development Board Building Board of Adjustment&Appeals Employees' Pension Board Police Officers'Retirement"Trust Fund Cemetery Board Firefighters'Pension Trust Fund Recreation &Parks Board Code Compliance Board Coif Course Advisory Committee Senior Advisory Board Community Relations Board Library BoardVeterans Advisory Commission* Board Preferences: 1 st choice please select a board.. Code Compliance Board member type please select.. Regular Member 2nd choice (optional) please select'a board.. member type please select.. 3rd choice(optional) please select'a board... 8t �rr,'6 typeplease select.. If Veterans Advisory Commission,list Branch of Military Service or Organization: V413\j3 Wha&j-$rsonal qualifications do you possess (i.e., profession, previous experience, branch of military service or organization)which you feel would mak6 you a good candidate for this board? Please be specific. I Have served on the Code Compliance Board for the past year, as a Permanent Member, and wish to continue in that capacity. I feel that the knowledge that I have gained about the workings of our board and it's First Choice: importance and impact to our community make me desire even more to remain on this board. I would greatly appreciate your consideration in re—appointing -me to this board again, as' a Permanent Member, Second Choice,[ hird Choice: Feel free to attach an extra sheet or resume. Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall.Mailing address: P,O- Box 310, Boynton Beach, FL 33425-0310 FAX to: (561)142-6090 It will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that,if appointed,any false statements may be cause for removal from a board, Signature: Date. 4�1 Page 2 of 4 CITY OF BOYNTON BEACH PrinrForm 'ADVISORY BOARD APPOINTMENT APPLICATION .Page 1.of 4 Thank you for your interest in serving on a City advisory board and for taking the time to fill out this form, Please print or type all answers clearly. If interest is expressed in appointment to more than one board, selections must be prioritized. If instructions are not followed or the application is not filled out in its entirety,the form will be returned for clarification. Name . 6 Jar Address City State .FL zipCodeF3 3 35�, Phone IVurnber -®� E-mail Address`O f� 0 o � ZSo1"r#.N�^, Current occupation or, if retired, prior occupation � - Education IWf Are you a registered voter? (tlfes {^No Do you,reside within the Boynton Beach City limits? t-r1fes C No Do you;own/manage a business within City limits? (-'Yes 9"NNo 1f"yes', name of business; Are you currently serving on a City board? Yes C No Have you served on a City board in the past? ^yes (?/No r\) r' co If so,,which board(s) and when? Have you ever been convicted of a crime? (' YeS' 940 PO C:) 00 If so,when? Where ? You may serve on only one board. Please Indicate which advisoryboard(s)you are seeking appointment AND whether as a regular member,alternate,or no preference.Prioritize up to three choices with number 1 being the most desired and 3 being the least preferable.For board listing,requirements,responsibilities and meeting times and dates,see pages 3 and 4 below, Arts Commission Education and Youth Advisory Board .Planning&Development Board Building Board of Adjustment&Appeals Employees'Pension Board Police Officers' Retirement7rust Fund Cemetery Board Firefighters`Pension Trust Fund Recreation & Parks Board Code Compliance Board Golf Course Advisory Committee Senior Advisory Board Community Relations Board Library Board Veterans Advisory Commission" Board Preferences: 1st choice [please select a board... member type please selecf. . 2nd choice (optional) please select a board... member type please select... )rd choice (optional); please select a board... member type please select.. *If Veterans Advisory Commission,list Branch of Military Service or Organization: What personal qualifications do you possess(i.e, profession, previous experience, branch of military service or organization)which you feel would make you,'good candidate for this board? Please be specific: Fw WtT14 P40At-r WHo ERNEjfLA ' 11�f T5'r5 rNAQ . $ 7' r First Choice: Second"Choice hird Choice: Feel free to attach an extra sheet or resume. Return the completed form to: City Clerk's Office, 100 East Boynton Beach Boulevard, City Hall.'Mailing;address: P.O. Box 310, Boynton Beach, FL 33425-0310 FAX to: (561)742-6090 It will be placed in the City's Talent Bank, a file to which Commissioners may turn for candidates when board openings occur. I hereby certify that the statements and answers provided herein are true and accurate. I understand that, if appointed, any false statements may be cause for removal from a board. p„ Signature: Date: r" Page 2 of,4