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Financial Advisory Committee application CITY OF BOYNTON BEACH FINANCIAL ADVISORY COMMITTEE APPOINTMENT APPLICATION MEETING DATE/TIME: To be determined. RESPONSIBILITIES: The City Commission has established a Financial Advisory Committee consisting of nine (9) members (7 regular and 2 alternate). The Committee has the general responsibility of reviewing the impact of legislative and administrative decisions on the City budget, revenue sources and operational expenditures and make recommendations that may favorably impact the City budget and overall financial condition. The Financial Advisory Committee will be responsible for reviewing and making recommendations on: the City’s proposed annual operating and capital budget; budget development systems and procedures; analyzing and recommending sources of revenues; employee salaries and benefits; pension and retirement benefits for City employees; operating expenditures and controls; reducing or controlling debt service requirements, and inter-fund transfers and loans. The foregoing examples are not intended to limit the scope of financial review that the City Commission may assign to the Committee from time to time. Specific tasks shall be delineated by the City Commission by majority vote. Thank you for your interest in serving on the Financial Advisory Committee and for taking the time to fill out this form. Please print or type all answers clearly. 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 State Zip Code email Phone Number Current occupation or, if retired, prior occupation: Education:SchoolYears CompletedDegree(s) High School(s): College(s): Are you a registered voter?Do you reside within the Boynton Beach City limits?Do you own/manage a business within the Boynton Beach City limits? If "yes", name and address of business: Are you currently serving on a City board?Have you served on a City board in the past? If so, which board(s) and when? Community Involvement: In addition to any City advisory advisory boards, please describe your community involvement using the space provided below:YesNoNoYesNoYesYesNoYesNoPage 1 of 3Print Form Boynton Beach FL Have you ever been convicted of a crime?YesNo If "yes", when? Where? What was the nature of the crime? Briefly describe why your service on the Financial Advisory Committee would be beneficial to the City of Boynton Beach: (Attach extra sheets as needed)It is desirous that the Financial Advisory Committee members represent a broad range of professional and technical competencies that would enhance the City’s financial health. Per Sec. 2-242 -Ordinance 10-009 -five of the regular members of the Committee shall have one of the following qualifications. Please mark which specific skill sets apply to your qualifications:AccountingBankingInsurance Prof. (property/casualty/health)Certified Financial PlannerBusiness Owner/ManagerPension Plan ManagementAuditingCertified Public AccountantFinancial Planning & ManagementInvestment AdvisorMPA or MBA degreeOther: please explain belowPlease provide at least three professional references: (Include full name, telephone and e-mail, if e-mail is available)Do you have any potential conflicts of interest that may arise from time to time? (A conflict of interest would be anything that inures to your benefit, your employer’s benefit or a member of your family’s benefit. Note: Having a potential conflict of interest does not necessarily exclude you from serving on the Financial Advisory Committee.)YesNoIf "yes", please explain:Page 2 of 3 * A resume must be submitted with this application for Financial Advisory CommitteePlease mail, fax, or deliver the completed, signed form and a copy of your resume to :City Clerk’s Office -City Hall 100 East Boynton Beach Boulevard P. O. Box 310, Boynton Beach, FL 33425-0310 FAX: (561) 742-6090I 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/committee. Signature:___________________________________________________ Date:______________________Page 3 of 3