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OVERTOWN COMMUNITY OVERSIGHT BOARD
APPLICATION FORM FOR APPOINTED MEMBERS
To be completed by the RECOMMENDER and to be submitted by 4:00 P.M. on FRIDAY, AUGUST 29, 2008 to the
office of the OVERTOWN NEIGHBORHOOD ENHANCEMENT TEAM (NE. T.), at 1490 N. W. 3RD.AVENUE; the office of the
DISTRICT 5 COMMISSIONER at 3500 PAN AMERICAN DRIVE or the office of the CITY CLERK at 3500 PAN
AMERICAN DRIVE. Note: A person may recommend himself/herself. -
A. 1 nominate 1 i ;ry. k._ �i -u for appointment to the Ovenown Community-Oversieht Board.„ .He/she„. .
meets the eligibility requirements because -he/she is 1.8 years of aee and also meets one or more of the following qualifications:
1. Resides in the Ovenown Area at ?7 ,C.L� q �.- 111 t`or
2. Is the current owner of property in the Ovenown Area located at:
or
3. 1s an employee or board member of community development
corporation or community based organization located in and provides services to the Ovenown Area, at the address
. or
47- Owns or is an employee of"a business in the Overtown-Area-located-at:
5. Nominee's Info:
Phone number %15(1) -S) — 1Z2 Cell phone /
FAX Number - E-mail (1 OOfL7:OLO7 C?1Gd G; SC/�05/. •
B. Please provide a short statement of qualifications of the person you are recommending for appointment:
' +1`l u k ;,^,rt 1 t.3a-t,L1Ct' lA coo d p-e it s
ram,.
!;etc .,- ± , Q
I UL v-E.r , )f ter; , nn i A (II -1-6 Oi.,t G r G cC c ( -
= n re ;' ry n vQo r� K i -4c)t _rv)C
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e jr-r_c !-t / 7 L b t G
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I h ()=.)-( (?tom- ' i i t r t l� �� !,k- ' '. r�� �% r Ym r E -tom.
•
C. Please provide your contact information for the urpose of clarifying the above and sign below
.. Phone number -/ Cell phone J 1tL
FAX number E-mail (t rtE i2n-i07 6' CP-\;r 1C
D. Please sign here ^.y
Signature
•
Printed Name
(t
Date /Signed/
FOR OFFICIAL USE ONLY:
-RECOMMENDED-P_ERSON_SADDRESS INSIDE BOUNDARIES? )' N • N/A -
RECOMMEND PERSON MEETS AGE REQUIREMENTS )' N -N/A
RECOMMENDED PERSON'S PROOF OF QUALIFICATION SUBMITTED:
ACCREDITED INSTITUTION INSIDE BOUNDARIES Y N -N/A
City of Miami
OVERTOWN COMMUNITY OVERSIGHT BOARD
APPLICATION FORM FOR APPOINTED MEMBERS
To be completed by the RECOMMENDER and to be submitted by 4:00 P.M. on FRIDAY, AUGUST 29. 2008 to the
office of the OVERTOIVA NEIGHBORHOOD ENHANCEMENT TEAM (N.E.T.), at 1490 N.W. 3ND AVEENUE; the office of the
DISTRICT 5 COMMISSIONER at 3500 PAN AMERICAN DRIVE or the office of the CITY CLERK at 3500 PAN
A i1ERICAN DRIVE. Note: A person may recommend himself/herself
A. 1 nominate L 1LL1/1-N) -✓ L TEA --forappointmenrto-the Oyenown-Comrnunity-Oversight--Board-He/she • ---
meets the eligibility requirements because/she is 18 years of age and also meets one or more of the following qualifications:
1 . Resides in the Overtown Area al � ,i '��t C "�;1>L=�}fG�. _ or
2. Is the current owner of property in the Overtown Area located at:
110140 is Ill-' - 'E 4 1 O-- L 1\? ;
Is an employee or board member of 1'c : �1 �LL/ '-- community de\elopment
corporation or community based oreanization located in and provides services ;o the Overtown Area, at the address
_i__=, it:, ?v L. 1 -4- .-'E1 is--n•. l ,
01
--- ----—47—Owns-or is an -employee -of a business inthe-Ocertown Area located at.
or
5. Nominee's Info: Phone number 1 ,-5`7}}5'} Ft Cell phone
FAX Number 3it,—S`"ri— "7-.$S E-mailsuts;k'c--
Please provide a shon statement of qualifications of the person you are recommending for appointment:
'/sue DG -- T o i! (eve-
d
.%r
C. Please provide your contact information for the purpose of clarifying the above and shin below
Phone number-IC5'1- L1--3 - Qji % h Cell phone
FAX number 3,,(��2�� <Iz E-mail
�. 4"...7*—'
Printed Name
t
4
�, ,,
3) 0Cam,
+
Date Siar,ed
.-FOR-"OFFICIAL USE ONLY:
RECOi`MENDED PERSON'S ADDRESS INSIDE BOUNDARIES? Y •
RECOMMEND PERSON MEETS AGE REQUIREMENTS • Y
RECOMMENDED PERSON'S PROOF OF QUALIFICATION SUBMITTED:
ACCREDITED INSTITUTION INSIDE BOUNDARIES Y
N/A
N/A
N N/A