CITY OF BOCA RATON
APPLICATION UPDATE FOR BOARD RE-APPOINTMENT


Please provide the following information to ensure that the City Clerk’s office has the most current information on file for all re-appointed board members. This form will be kept with your original application.


NAME:*    HOME ADDRESS:*

CITY:*    ZIP CODE:*

E-MAIL:*    BUSINESS NAME:

OCCUPATION:    BUSINESS ADDRESS:

HOME PHONE:*    BUS. PHONE:

CELL PHONE:

WHICH BOARD/COMMITTEE ARE YOU RE-APPLYING FOR?  

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 ADVISORY COMMITTEE:
(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.