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<br />e <br />-tP. CoJ e R tv j'ttJ <br />fire.,. <br /> <br />CITY OF LA PORTE <br /> <br />.IO~/ <br /> <br />(r <br /> <br />APPLICATION FOR CITY BOARDS / COMMISSIONS <br /> <br />NOTE: As an applicant for a City Board or Commission, your name, address and phone <br />number may be available. to the press and the public. You have the right to request the <br />exclusion of certain information from press and public access. All other information will <br />remain confidential. You will be contacted before any action is taken on your <br />appointment. Incumbents whose terms expire are automatically considered for <br />reappointment, upon request. A member who is absent for more than 25 % of called <br />meetings, for other than medical reasons, will be subject to removal by City Council. <br />Final decisions on appointment and reappointment of members of Boards and <br />Commissions rests with the City Council. APPLICANT MUST BE A CIT.IZEN OF <br />THE UNITED STATES; A RESIDENT OF THE CITY OF LA PORTE; AND A <br />QUALIFIED VOTER IN THE CITY OF LA PORTE. MEMBERS OF THE <br />pLANNING AND ZONING COMMISSION MUST ALSO BE RESIDENTS OF <br />ONE OF THE CITY COUNCIL DISTRICTS FROM WIDeH THEY ARE <br />APPOINTED. <br /> <br />Please type or urint clearly <br />Name: (Jo (fJ(t 6W <br /> <br />Address: ]a-O 1{{ 0 J g Y.j e e (l ~ D (l., <br /> <br />S"' elJ g r '1,d- <br /> <br />City: LA PI (,I:!'" State/Zip: TX - 7757) <br /> <br />DATE: nJ J '/ 13 ')0' 0- <br />Phone~rl- Vl/-/JIP h <br />(W) ee "~ (2ff'D <br /> <br />'- <br /> <br />Are you a registered voter in the La Porte City limits? @ or N <br />Did you vote in the last City election?(!) or N <br />Please indicate your Dreference bv number. 1-2-3. etc. <br /> <br />ADVISORY BOARDS AND COMMISSIONS <br />_ Airport Advisory Board <br />_ Chapter 172 Employee/Retiree Insurance Benefits Committee <br />_ La Porte Health Authority <br />Main Street Advisory Board <br />- <br />_ Youth Advisory Council <br /> <br />56 <br />