CITY OF BOCA RATON
                                                                                        APPLICATION FOR APPOINTMENT
                                                                             NORTH FEDERAL HIGHWAY STEERING COMMITTEE


NAME:*    HOME ADDRESS:*

CITY:*    ZIP CODE:*

E-MAIL:*    BUSINESS NAME:

OCCUPATION:    BUSINESS ADDRESS:

HOME PHONE:*    BUS. PHONE:

CELL PHONE:

The boundaries of the Master Plan area are north of Yamato Road to the north City limit and east of the Florida East Coast Railroad right-of-way to the Intracoastal Waterway. The committee consists of eleven (11) members from the North Federal Highway Master Plan area and the City at large as follows:
(Please check appropriate box or boxes):
Two (2) Commercial Property Owners (or Property Manager as identified by a Commercial Property Owner), who need not be residents in the Master Plan Area
           
*If Property Manager, please attach letter of authorization from Property Owner.
Four (4) Residential Property Owners residing in the Master Plan area
One (1) Large Scale Business Owner, who need not be a resident in the Master Plan area (not a property owner, more than 20 employees)
One (1) Small Scale Business Owner, who need not be a resident in the Master Plan area (not a property owner, 20 or fewer employees)
Three (3) Residential Property Owners who need not be a resident in the Master Plan area but who are residents of the City.

ARE YOU A VENDOR OR EMPLOYED BY A VENDOR OF THE CITY OF BOCA RATON?*


ARE YOU A LOBBYIST OR EMPLOYED BY A LOBBYIST AS DEFINED IN THE PALM BEACH COUNTY LOBBYIST REGISTRATION ORDINANCE?*


BRIEFLY DESCRIBE WHY YOU WISH TO SERVE AS A MEMBER OF THIS COMMITTEE:
(600 Character limit)  


EDUCATIONAL BACKGROUND:
    University attended:
    Degrees received:
    Major area of study:

PROFESSIONAL BACKGROUND/CERTIFICATION:
(600 Character limit)  


Board interviews are conducted at City Council Workshop and Regular Meetings, which are generally held the 2nd and 4th Mondays and 2nd and 4th Tuesdays, respectively, of each month. Workshop Meetings begin following the conclusion of the Community Redevelopment Agency meeting that is scheduled to begin at 1:30 p.m. and Regular Meetings commence at 6:00 p.m. in the City Hall Council Chamber. Applicants are notified of vacancies and interview dates prior to the scheduled interview. Applications are kept on file in the City Clerk's Office for a period of one year. Applicants may supplement their application with a resume or other information relevant to their qualifications.

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Select your resume: (Resume cannot exceed 2MB file size.)
 


TERMS OF ACCEPTANCE

Declaration of Personal Information Exemption

Personal information provided in this application is public information unless the applicant qualifies for an exemption pursuant to Florida Statutes. You are encouraged to thoroughly read the applicable sub-sections of F.S. 119.071. If you qualify for an exemption, please indicate below which statutory provision you are citing for the exemption. If you qualify, your address and phone number are protected information. You may contact the Board Coordinator at 393-7743 if you have any questions.

My address and telephone number are statutorily exempted from public disclosure, pursuant to Section  of Florida Statutes.

Signature

I understand the duties and responsibilities of the board(s) or committee(s) for which I am applying. By signing below, I warrant the truthfulness and accuracy of the information provided in this application, including that applicable to any personal information exemptions.



Signature of Applicant:*
                                               Please type your First and Last Name
Date:*

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.