HomeMy WebLinkAbout2020 11 17 Marino, Gerry Application (CEB) City of Winter Springs, FL Boards & Commissions Submit Date: Nov 17, 2020
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.
Gerry M Marino
I I...............................................
First Narne Middle Initial Last Narne
880 Bentley Green Circle
I-lorne Address Suite or Apt
Winter Springs FL 32708
11......................................................................................................City State Postal Code
What district do you live in?
�W District 3
gerrymarino55@yahoo.com
Email Address
Mobile: (407) 376-7536 Home: (407) 366-5053
Primary Phone Alternate Phone
Retired
Occupation
is Boards would you like to apply for?
Veteran and Veteran Family Advisory Committee: Submitted
Eligibility
Are you duly registered to vote in Seminole County?
r Yes r No
Are you duly registered to vote in the City of Winter Springs?
r Yes r No
Do you live within the city limits of Winter Springs
r Yes r No
How long have you been a resident of Winter Springs?
27 years
Gerry M Marino
Have you ever been convicted or found guilty, regardless of adjudication, of a felony in any
jurisdiction?Any plea of nolo contenders (no contest) shall be considered a conviction for
the purposes of this question.
r Yes r No
Do you currently serve on any other City of Winter Springs board or committee?
r Yes r 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?
r Yes r 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?
r Yes r No
Are you related to a City of Winter Springs Commission member by blood, adoption, or
marriage?
r Yes r No
Question applies to Veteran and Veteran Family Advisory Committee
Select one of the following *
�W Veteran of the U.S. military discharged or released therefrom under conditions other than
dishonorable
If yes to the above, please provide relation
1a Veteran and Veteran Family Advisory Committee
Please upload a copy of one of the following:
Military/Veteran ID OR proof of organization serving
veterans&your role
Interest & Experiences
by are you interested in serving on a board or committee?
I have served in the Armed Forces for 24 years, retired as a Master Sergeant (E-8), Belong to them
Merine Corps Foundation. Interested in helping veterans in the City of Winter Springs. I can be a strong
advocate for the cause.
Gerry M Marino
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 out miltitary procedures and customs,will be able to guide the commission when issues
comes up
Briefly state any experience you have in serving on any governmental board or committee.
I have volunteer on many boards, not in government, but civilian boards: i.e., Chamber boards, Rotary,
Foundation Board for Seminole County Schoola. Been President and member as well.
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
�W Caucasian/Non-Hispanic
Gender*
�W Male
08/13/1955
Date of Birth
Do you have a physical disability?
r Yes r 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
�W 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.
�W I Agree
Gerry M Marino