HomeMy WebLinkAbout2023 03 21 Wallis, Mary Application.pdfSubmit Date: Mar 21, 2023
First Name Middle Initial Last Name
Home Address Suite or Apt
City State Postal Code
Email Address
Primary Phone Alternate Phone
Occupation
City of Winter Springs, FL Boards & Commissions
Application Form
Profile
Please be aware that documents submitted to the City are public records available for
inspection to the extent allowed by Chapter 119, Florida Statutes.
What district do you live in?
District 3
Which Boards would you like to apply for?
Tuscawilla Lighting & Beautification District Advisory Committee: Submitted
Eligibility
Are you duly registered to vote in Seminole County?
Yes No
Are you duly registered to vote in the City of Winter Springs?
Yes No
Do you live within the city limits of Winter Springs
Yes No
How long have you been a resident of Winter Springs?
3 years
Mary Susan Wallis
607 S PINTO CT
Winter Springs FL 32708
days261@gmail.com
Home: (407) 741-3412 Business: (407) 832-4648
Deputy Sheriff, Orange County
Sheriff's Office
Mary Susan Wallis
Have you ever been convicted or found guilty, regardless of adjudication, of a felony in any
jurisdiction? Any plea of nolo contendere (no contest) shall be considered a conviction for
the purposes of this question.
Yes No
Do you currently serve on any other City of Winter Springs board or committee?
Yes No
If yes to the above, please list each
Do you have any private or personal interests which might conflict with serving the City's
interests if you were to be appointed to serve on this board or committee?
Yes No
City ordinance requires that all persons applying for a City board or committee must
voluntarily consent to a standard criminal background check before being appointed to a
board or committee. Do you voluntarily consent to having a standard background check
being performed on you by the City of Winter Springs?
Yes No
Are you related to a City of Winter Springs Commission member by blood, adoption, or
marriage?
Yes No
If yes to the above, please provide relation
Interest & Experiences
Why are you interested in serving on a board or committee?
I live in the city and would like to become more involved in my community. I'm getting closer to retirement
in my profession and would like to stay involved and active as I move towards retirement.
Briefly state any specialized knowledge or prior experience you have that would be useful in
assisting the board or committee in accomplishing its purpose.
I am familiar with Florida State Statutes as I am a sworn law enforcement officer in Florida.
Briefly state any experience you have in serving on any governmental board or committee.
I currently oversee the Nuisance Abatement Squad for the Orange County Sheriff's Office which presents
to the Orange County Nuisance Abatement Board. As head of Narcotics for the Orange County Sheriff's
Office I am a member of the OC Opioid Advisory Committee. These are appointments based on my
position in the Sheriff's Office.
Mary Susan Wallis
Date of Birth
Financial Disclosure Requirement
Question applies to Planning and Zoning Board/Local Planning Agency,Code Enforcement Board,Board of Trustees
Please Agree with the Following Statement
All members of the Board of Trustees, Code Enforcement Board, and Planning and Zoning
Board are required to annually file a Form 1 - Statement of Financial Interests. By clicking "I
Agree" you are stating you understand and agree to comply with this requirement if
appointed to one of these Boards.
I Agree
State Reporting Requirements
Florida law requires that the City annually submit a report to the Secretary of State disclosing race,
gender, and physical disabilities of board and committee members.
Ethnicity *
Caucasian/Non-Hispanic
Gender *
Female
Do you have a physical disability?
Yes No
Please Agree with the Following Statement
You hereby represent to the City of Winter Springs under penalties of perjury that the
information provided herein is true and accurate to the best of your knowledge and the City
of Winter Springs has the right to rely on that information
I Agree
Please Agree with the Following Statement
You hereby acknowledge the existence of the Code of Ethics for Public Officers and the
Florida Sunshine Law which may pertain to you if you are appointed to a City Board or
Committee. If appointed it is your sole obligation and duty to comply with such laws.
I Agree
01/11/1966
Mary Susan Wallis
Submit Date: Mar 21, 2023
First Name Middle Initial Last Name
Home Address Suite or Apt
City State Postal Code
Email Address
Primary Phone Alternate Phone
Occupation
City of Winter Springs, FL Boards & Commissions
Application Form
Profile
Please be aware that documents submitted to the City are public records available for
inspection to the extent allowed by Chapter 119, Florida Statutes.
What district do you live in?
District 3
Which Boards would you like to apply for?
Code Enforcement Board: Submitted
Eligibility
Are you duly registered to vote in Seminole County?
Yes No
Are you duly registered to vote in the City of Winter Springs?
Yes No
Do you live within the city limits of Winter Springs
Yes No
How long have you been a resident of Winter Springs?
3 years
Mary Susan Wallis
607 S PINTO CT
Winter Springs FL 32708
days261@gmail.com
Home: (407) 741-3412 Business: (407) 832-4648
Deputy Sheriff, Orange County
Sheriff's Office
Mary Susan Wallis
Have you ever been convicted or found guilty, regardless of adjudication, of a felony in any
jurisdiction? Any plea of nolo contendere (no contest) shall be considered a conviction for
the purposes of this question.
Yes No
Do you currently serve on any other City of Winter Springs board or committee?
Yes No
If yes to the above, please list each
Do you have any private or personal interests which might conflict with serving the City's
interests if you were to be appointed to serve on this board or committee?
Yes No
City ordinance requires that all persons applying for a City board or committee must
voluntarily consent to a standard criminal background check before being appointed to a
board or committee. Do you voluntarily consent to having a standard background check
being performed on you by the City of Winter Springs?
Yes No
Are you related to a City of Winter Springs Commission member by blood, adoption, or
marriage?
Yes No
If yes to the above, please provide relation
Interest & Experiences
Why are you interested in serving on a board or committee?
I live in the city and would like to become more involved in my community. I'm getting closer to retirement
in my profession and would like to stay involved and active as I move towards retirement.
Briefly state any specialized knowledge or prior experience you have that would be useful in
assisting the board or committee in accomplishing its purpose.
I am familiar with Florida State Statutes as I am a sworn law enforcement officer in Florida.
Briefly state any experience you have in serving on any governmental board or committee.
I currently oversee the Nuisance Abatement Squad for the Orange County Sheriff's Office which presents
to the Orange County Nuisance Abatement Board. As head of Narcotics for the Orange County Sheriff's
Office I am a member of the OC Opioid Advisory Committee. These are appointments based on my
position in the Sheriff's Office.
Mary Susan Wallis
Date of Birth
Financial Disclosure Requirement
Question applies to Planning and Zoning Board/Local Planning Agency,Code Enforcement Board,Board of Trustees
Please Agree with the Following Statement
All members of the Board of Trustees, Code Enforcement Board, and Planning and Zoning
Board are required to annually file a Form 1 - Statement of Financial Interests. By clicking "I
Agree" you are stating you understand and agree to comply with this requirement if
appointed to one of these Boards.
I Agree
State Reporting Requirements
Florida law requires that the City annually submit a report to the Secretary of State disclosing race,
gender, and physical disabilities of board and committee members.
Ethnicity *
Caucasian/Non-Hispanic
Gender *
Female
Do you have a physical disability?
Yes No
Please Agree with the Following Statement
You hereby represent to the City of Winter Springs under penalties of perjury that the
information provided herein is true and accurate to the best of your knowledge and the City
of Winter Springs has the right to rely on that information
I Agree
Please Agree with the Following Statement
You hereby acknowledge the existence of the Code of Ethics for Public Officers and the
Florida Sunshine Law which may pertain to you if you are appointed to a City Board or
Committee. If appointed it is your sole obligation and duty to comply with such laws.
I Agree
01/11/1966
Mary Susan Wallis
Submit Date: Mar 21, 2023
First Name Middle Initial Last Name
Home Address Suite or Apt
City State Postal Code
Email Address
Primary Phone Alternate Phone
Occupation
City of Winter Springs, FL Boards & Commissions
Application Form
Profile
Please be aware that documents submitted to the City are public records available for
inspection to the extent allowed by Chapter 119, Florida Statutes.
What district do you live in?
District 3
Which Boards would you like to apply for?
Parks and Recreation Advisory Committee: Submitted
Eligibility
Are you duly registered to vote in Seminole County?
Yes No
Are you duly registered to vote in the City of Winter Springs?
Yes No
Do you live within the city limits of Winter Springs
Yes No
How long have you been a resident of Winter Springs?
3 years
Mary Susan Wallis
607 S PINTO CT
Winter Springs FL 32708
days261@gmail.com
Home: (407) 741-3412 Business: (407) 832-4648
Deputy Sheriff, Orange County
Sheriff's Office
Mary Susan Wallis
Have you ever been convicted or found guilty, regardless of adjudication, of a felony in any
jurisdiction? Any plea of nolo contendere (no contest) shall be considered a conviction for
the purposes of this question.
Yes No
Do you currently serve on any other City of Winter Springs board or committee?
Yes No
If yes to the above, please list each
Do you have any private or personal interests which might conflict with serving the City's
interests if you were to be appointed to serve on this board or committee?
Yes No
City ordinance requires that all persons applying for a City board or committee must
voluntarily consent to a standard criminal background check before being appointed to a
board or committee. Do you voluntarily consent to having a standard background check
being performed on you by the City of Winter Springs?
Yes No
Are you related to a City of Winter Springs Commission member by blood, adoption, or
marriage?
Yes No
If yes to the above, please provide relation
Interest & Experiences
Why are you interested in serving on a board or committee?
I live in the city and would like to become more involved in my community. I'm getting closer to retirement
in my profession and would like to stay involved and active as I move towards retirement.
Briefly state any specialized knowledge or prior experience you have that would be useful in
assisting the board or committee in accomplishing its purpose.
I am familiar with Florida State Statutes as I am a sworn law enforcement officer in Florida.
Briefly state any experience you have in serving on any governmental board or committee.
I currently oversee the Nuisance Abatement Squad for the Orange County Sheriff's Office which presents
to the Orange County Nuisance Abatement Board. As head of Narcotics for the Orange County Sheriff's
Office I am a member of the OC Opioid Advisory Committee. These are appointments based on my
position in the Sheriff's Office.
Mary Susan Wallis
Date of Birth
Financial Disclosure Requirement
Question applies to Planning and Zoning Board/Local Planning Agency,Code Enforcement Board,Board of Trustees
Please Agree with the Following Statement
All members of the Board of Trustees, Code Enforcement Board, and Planning and Zoning
Board are required to annually file a Form 1 - Statement of Financial Interests. By clicking "I
Agree" you are stating you understand and agree to comply with this requirement if
appointed to one of these Boards.
I Agree
State Reporting Requirements
Florida law requires that the City annually submit a report to the Secretary of State disclosing race,
gender, and physical disabilities of board and committee members.
Ethnicity *
Caucasian/Non-Hispanic
Gender *
Female
Do you have a physical disability?
Yes No
Please Agree with the Following Statement
You hereby represent to the City of Winter Springs under penalties of perjury that the
information provided herein is true and accurate to the best of your knowledge and the City
of Winter Springs has the right to rely on that information
I Agree
Please Agree with the Following Statement
You hereby acknowledge the existence of the Code of Ethics for Public Officers and the
Florida Sunshine Law which may pertain to you if you are appointed to a City Board or
Committee. If appointed it is your sole obligation and duty to comply with such laws.
I Agree
01/11/1966
Mary Susan Wallis