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Home My WebLink About2020 05 04 Kaprow, Maurice Application for ReappointmentCITY OF WINTER SPRINGS APPLICATION FOR APPOINTMENT TO CITY BOARD/COMMITTEE Applications may be submitted in person at City Hall, facsimile (407-327-4753), or email, CityClerkDepartment@winterspringsfl.org). Applicants may attach a resume, references, recommendations, or other such documentation that the applicant desires to have the City Commission consider. Please be aware that documents submitted to the City are public records available for inspection to the extent allowed by Chapter 119, Florida Statutes. Please complete the following in the space provided: A. GENERAL 1.Name: N4 3.Occupation: IV,t--e-4 4.Telephone (cell): Telephone (other): 5.Email: B. ELIGIBILITY The information provided in this section is for purposes of determining whether you are eligible to serve on a City board or committee: 1 a. Are you duly registered to vote in Seminole County:Y)Z(N) 1 b. Are you duly registered to vote in the City of Winter Springs? Y) i/ (N) 2a. Do you live within the City limits of Winter Springs: Y)_Z(N) 2b. What district do you reside in? 1) (2)_ (3) (4) (5) 2c. How long have you been a resident of the City? _ Z t4-O 3 3.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 purposes of this question. Y) (N) 4a. Do you presently serve on any other, City of Winter Springs board or committee? Y)v" (N) 4b. Please list each: 5.Do you have any private or personal interests which might conflict with serving the City' interests, if you were to be appointed to serve on this board or committee? Y) (N) 6.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 chec being performed on you by the City of Winter Springs? Y) V (N) 6a. Are you related to a City of Winter Springs Commission member by blood, adoption or marriage? Y)_ (N) 6b. If yes to 6a, please provide relation: C. INTEREST AND EXPERIENCE Please see attached descriptions for each of the following boards or committees and indicate below on which board or committee you wish to serve. Please indicate your preference with a one (1) indicating your first choice and rank any additional choices with successivenumbering. 1.Please indicate to which board or committee you are applying: Bicycle and Pedestrian Advisory Committee Board of Trustees de Enforcement Board Districting Commission (every 3 years, 2016) Oak Forest Wall and Beautification District Advisory Committee Parks and Recreation Advisory Committee Planning and Zoning Board/Local Planning Agency Tuscawilla Lighting and Beautification District Advisory Committee Other/Ad Hoc Committee 2.Briefly state why you are interested in serving on this board or committee (attach additional sheets as needed if interested in more than one Board): rn.P.rr- 3.Briefly state any specialized knowledge or prior experience you have that would be useful in assisting the board or committee in accomplishing its purpose (attach additional sheets as needed if interested in more than one board): rF c ii h 4.Briefly state any experience you have in serving on any governmental board or committee: D. 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. Please check the appropriate boxes: RACE GEND R African-American Male Asian-American Female Hispanic-American Not Known ative American Caucasian DISAI34LITY Not Known lzphysically disabled 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. 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. Signature: Date: Please return to: City of Winter Springs The Office of the City Clerk 1126 East State Road 434 Winter Springs, Florida 32708 2799 IN RECEIVED By Christian Gowan at 3:13 pm, May 04, 2020 Revised 5/13/2015 Christian Gowan From: Charlene Pike <pike@voteseminole.org> Sent: Monday, May 4, 2020 4:24 PM To:Christian Gowan Subject: Re: Winter Springs Voter Registration Confirmation EXTERNAL EMAIL: CaIIIi:IILfIoiV"iN„ D tlVfll;d gtick m ggtlV<s r1 rpxm "'Irly lI's untlV "ss y pu"II'lasi, ari l q<ril r%Av p'bVlA",gpll; 'b.l!! s" l', I Hi Christian, He has been registered at that address since 2/7/2008. Have a great week, Charlene Pike Chief Administrative Officer Representing Chris Anderson Seminole County Supervisor of Elections 407-708-7706 yolggnunoue.org yolognunoue.org SUL PL IS ,R OF ELECTIONS Under Florida law,email addresses are public records.Ifyou do not want your email address released in response to a public-records request,do not send electronic mail to this entity.Instead,contact this office by phone or in writing. On Mon, May 4, 2020 at 3:34 PM Christian Gowan<c owan(ea,wintersprin s >wrote: Good afternoon, At your earliest convenience,could you please advise if your records show the following individual as a registered Winter Springs voter? Maurice Kaprow 1 Winter Springs, FL 32708 If so, can you please advise as to how long the individual has been registered at this address? Thankyou Christian Gowan0000o Interim City Clerk 407) 327-6560 : (407) 327-4753 1126 East State Road 434 Nllu Winter Springs, Florida 32708 00001 quua^amw•ttuaa m nm n ON N i iA; III os•afklenfl ak)} N4otr l'Ns r -a may , usaa usa, ,mfl mhmcnt to ft c op•atas ns nf+;;oswam fl os•a ntesa+kd+:ns ) for tho uso of tho r fi,,'ds:k u!d°",o or ent¢t), m,macd on tho r-nm'H &t tho Wea iJr;; of tNs e-x?mH ps not tho pntcmma e J W"w(;:rpkmt,o; tho r mN'yAo;'ee or IVgent pe',H„vr;r"?,,bk)foy der +I"Q'dng pt t o tho pd?tcx?akd W"r u`qppcnt You VW"e h+rebh'Y n otifiod t,hsO' r aiJrn+ ft s st,rrctly proh'Ntc iJ ff You Nr,e r c o r,od tNs r-n m'H rn r m r,p aso r t°Urn'ft to tho ;oml uml dc cte'ft t'aom Yrour; st m,"h usak You Under Florida taw,email addresses are public records.If you do not want your email address released in response to a public-records request do not send electronic mart to this entity.Instead,contact this office by phone or in writing. 2