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HomeMy WebLinkAboutParsons, Sabrina - Application for Office of the Mayor - 2021 04 01 RECEIVED APR 0 12021 CITY OF WINTER SPRINGS CITY OF WINTER SPRINGS, FLORIDA OFFICE OF THE CITY CLERK QUALIFYING APPLICATION FOR APPOINTMENTTO MAYOR SEAT THE ORIGINAL QUALIFYING APPLICATION AND ALL OTHER DOCUMENTS MUST COMPLETED WITH ORIGINAL SIGNA TURESAND MUST BE FILED IN THE CITY CLERI'CS OFFICE B YNOON ON THURSDAY,APRIL 1,2021. Qualified candidates may attach a resume, references, recommendations, or other such documentation that the candidate desires to have the City Commission consider before making an appointment to fill the unexpired term of the Office of Mayor. The Mayor serves on the governing body of the City subject to the duties and responsibilities specified in the City Charter. 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 Name: 1. o- 2. Home Address: [�q T�PPI 3. Occupation: —n—ro—c—LM— a , . 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 the City Commission: la. Are you duly registered to vote in Seminole County: (Y)JL(N)_ lb. Are you duly registered to vote in the City of Winter Springs? (Y),'—( (N)_ 2a. Do you live within the City limits of Winter Springs: (Y) 'k (N)_ 2b. What district do you reside in? (1)—(2)— (3)—(4)—(5) 2c. How long (years and/or months) have you resided in the district selected in 2b? 2d. How long (years and/or months) have you resided in the City? 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) ItECEIVED APR 01 1011 R SPRINGS 4a. Do you presently serve on any other City of Winter Springs I�o E CITY CLERK committee? (Y)—(N)� 4b. Please list each: S. 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? (Y)—(N)- 6. All persons applying for a City Commission Seat must voluntarily consent to a standard criminal background check before being appointed. Do you voluntarily consent to having a standard background check being performed on you by the City of Winter Springs? (Y)—(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: 7. 1 have read the attached information detailing the duties and powers of the Mayor and the Rules and Procedures of the City Commission. (Y)—(N)— NOTE: The City of Winter Springs'City Commission has requested and encourages you to submit: 1) A brief Bio (to include background information,information related to any applicable qualifications and current/previous community service) 2) Information related to why you would be a good candidate to fill this open Mayor Seat 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 SERVE AS MAYOR. IF APPOINTED IT IS YOUR SOLE OBLIGATION AND DUTY TO COM WITH SUCH LAWS. Signature: r(1 111f-)64LJ� 4-1,0 127� - Date: ( 7 2) Ilo Lgoal Please return to: City of Winter Springs The Office of the City Clerk 1126 East State Road 434 Winter Springs, Florida 32708 2799 THE ORIGINAL QUALIFYING APPLICATION AND ALL OTHER DOCUMENTS MUST BE COMPLETED WITH ORIGINAL SIGNATURESAND MUST BE FILED IN THE CITYCLEWS OFFICE By NOON ON THURSDAY, APRIL 7, 2027 FAILURE TO TIMELY FILE AN APPLICATION MAYRESULT IN YOUR APPLICATION NOT BEING CONSIDERED BY THE CITY COMMISSION. Revised 3/23/2021 zcFiVED APR 012021 CITYOFWNT-1 OFFICE OF ' My husband, children and I have been proud to call Winter Springs home for nearly two decades. I was blessed to be a stay-at-home mom of three beautiful children, Alexa, Dylan and Howie for nine of those years. Our children attended Winter Springs Elementary, Keeth Elementary, Indian Trails Middle School and Winter Springs H igl-t School. I was honored to serve on the Winter Springs Elementary School Board as Yd Vice President, serve the Cub Scouts for five years from Secretary to Committee Chair and serve the Girl Scouts as a scout leader. While attending college, I volunteered at the Christian Sharing Center for one year and at Kids House of Seminole. In 2012 1 earned my second degree, a bachelor's in human services with an emphasis on child & family welfare. Within weeks of graduation, I was offered a position with the Department of Children & Families. I have had the pleasure of growing within the Department and serving the members of our community since April 2012. Currently I am an Operations Management Consultant I and have plans to continue growing. Serving my community and helping those in need become more self- sufficient has been an absolute pleasure. From here, I have realized that my passion is to make change and to make change, you need to start from the bottom and work your way up. No matter where my path leads, I know that God will be leading it. Respectively, Sabrina Parsons 1049 Chokecherry Dr. Winter Springs, FL 32708 407-733-9554 Sabpar2@hotmail.com IV ED APR 01 2021 CITY OF WNTER SPRINGS OFFICE OF THE CITY CLLRK In any leadership position, the following attributes should be displayed: • Integrity • Ethics • Forward thinking • Empathy • Decisiveness • Inspiration • Teamwork • Humility • Open-mindedness I believe that I display those qualities. Being Mayor, to me, is about bringing your team together to find a common interest in serving your community. Although I am not the "typical" mayoral candidate, I do bring management experience through my volunteering, raising children and through my career with the State of Florida. I am however the "typical" Winter Springs citizen which allows me to connect to and serve our city. My passion and desire are to help and serve others. I have no ties to politics or have a desire in political gain. My interest is to serve our community and the residents of Winter Springs by promoting transparency between local government and to promote engagement of our citizens. Respectfully, Sabrina Parsons 1049 Chokecherry Dr. Winter Springs, FL 32708 407-733-9554 Sabpar2�7ahotmail.com APR 01 2021 --~ CITY uFWINTER SPRINGS EXPERIENCE orF/oenFn+e �n'CLERK PARSONS SABR|NA DCF ACCESSSUOMC IUORLANDO, FL DCF ACCESS OMC 1 0 - CURRENT Responsibilities include mentoring and guiding staff, including the unit Supervisors, ESSS|| anSSR's. Responsibilities also include OBJECTIVE performing monthly and annual evaluations onall staff under my Career focused with astrong supervision. Other employee related activities include daily, commitment toserving the needs '- vveeNyand noonth|yennp|oyeereports, data and/»r�rrortrend ofthe community, department analysis, providing advice toleadership regarding technical, and the team. ' systems related and operational processes, identifying the agency's needs inchanges ofcircumstances,scheduling employee leave. Fulfilling continuing education requirements to QUALITIES better the team aswell asgive back tothe community.The Forward looking,career focused, ability torepresent the Department ofChildren & Families inside compassionate, inspirational, oroutside ofthe organization. passionate,confident, rnu!titasker, detail oriented, transparent and DCF ACCESSS U ESS SUPERVISOR 0 ORLANDO, FIL trustworthy [)7/7[)16-01/7(l2(] Responsibilities include all ESSS|| level responsibilities; mentoring VITALS and guiding staff, including the unit ESSSU. Responsibilities also 1O49Chokecherry Dr include per��rrningquality reviews on E3SS11 and performing' Winter Springs, FL 32708 monthly and annual evaluations onall other staff inthe unit. Other employee related activities include daily, weekly and Phone:407-733-9554 monthly employee reports and scheduling employee leave. Email:sabpar3@hmtnnai|.conn Fulfilling continuing education requirements tobetter the team aswell asgive back tothe community. Face toface customer contact while working inthe storefront and telephone contact as needed are responsibilities exercised daily. DCF ACCESS U ESSSIU U ORLANDO, FL 08/2013 -07/2016 Responsibilities include all ES58level responsibilities; mentoring and guiding staff, performing quality management reviews, running daily reports and maintaining a daily caseload. Daily activities include customer contact through storefront and telephone communication toensure excellence service and afull customer understanding, Activities also include maintaining proper and accurate case records and interactions with quality assurance team aswell asupper management.Continuing education opportunities are utilized inaneffort tobetter the team aswell asthe customer experience, 2 APR 012021 DCF ACCESS I ESSSI I ORLANDO, FL CITY OF WNTFR SPR NGS PARSONS, SAB.RllJA 04/2012-08/2013 C)Fri r,,z. -T,-I 1-�C':TY Y C L ER K DCF ACCESS OMC I Responsibilities include processing and approving applications for food assistance, Medicaid, and temporary cash assistance in a manner that complies with State and Federal guidelines. Responsibilities include proper case load management to ensure all procedural guidelines are met. Client interviews, questions and concerns are handled daily to ensure proper customer service standards are continually met. CHRISTIAN SHARING SERVICE I CLIENT SERVICES SANFORD 10/2011-4/2012 This volunteer position responsibility included client intake and client services. Interviewing clients face to face and gathering all the necessary paperwork to determine qualifications for services. Duties also included the use of specific databases to fill out client's information. Informing and referring clients for other services in Seminole County were required as well. BURGER KING I MANAGER I PA& FL 06/1997-02/2002 On a daily basis duties included inventory, bank deposits, scheduling,ordering and the required paperwork to be entered into the computer. Duties also included training new crew members, customer service and food preparation. KEISER UNIVERSITY I ASSIOCIATE DEGREE IN MEDICAL ASSISTANT 12/2009 KAPLAN UNIVERSITY BACHELOR OF SCIENCE IN HUMAN SERVICES WITH AN EMPHASIS IN CHILD AND FAMILY WELFARE 104/12 HONORS, AMARDS ,-& VOLUNNIFEER ?0SITIONS Lean Six Sigma PECEIVED APR 01 2021 0[F[RLA2D1Q�raduate PARSONS, ����(�� ~ — cr�oF,wmTrnSPRINGS ' or�n=c~THF rITvCLERK DCF ACCESS OMC | Unit Award O1/2O17 Customer Service Award O6/2U16 Customer Service Award 0A/ZOI4 Cub Scout Secretary 2013-2O16 Cub Scout Popcorn Kernel 2U14-2O18 Cub Scout Committee Chair 2O1G-2O18 President honor roll–Kaplan 2O1O-2OI2 Dean's List– Keiser University 2OO8-2OO9 Volunteered atChristian Sharing Center and Kids House 2OlI– ZO12 Girl Scout Leader 2O1O AVVANA[b–Leader IOIO-2O12 Church Preschool 2OO8-2O17 3'a Vice president PTA Board 2OOG–ZOO8 �����������r�~ ,^"_u "_.^"_""^~���� RECEIVE— APR —APR 012021 \°d TER 1TY of WINTER SPRING`:: CITY OF WINTER SPRINGS,FLORIDA -ICF OF THE CITY CLFR 2021 MAYOR APPOINTMENT Z THIS COMPLETED i .� FORM MUST BE ~`��sle AFFIDAVITOFQUALIFIED VOTERSTATUSAND wEs�'g CITYAND DISTRICT RESIDENCY PROVIDED TO THE CITY CLERK NO OFFICE OF THE MAYOR LATER THAN NOON ON THURSDAY, APRIL 1,2021 I do hereby state that I seek appointment to the City Name of Candidate(print or Type) of Winter Springs' Mayor of the City of Winter Springs to complete a four(4)year term previously held by Mayor Charles Lacey for the City of Winter Springs,Florida.I further swear or affirm: 0.) 1 am a qualified voter in the City of Winter Springs �^ (2.) My legal place of residence is: l�^�1� C..YIC;W, _�)1" „�� { �pf `1. , '6&Z0E� StreetAddress City State zip Code (3.) Length of time of residency in the City of Winter Springs is: (4.) 1 a ttaching two(2)documents,one to be a Florida Driver's License,as verification of my residency in the Ci f jpriings.T econd document is: Signature Date �Z�ip G f( r c LStreetAdd, Crty State e State of Florida County of ye M 1,r)0 Af Sworn to(or affirmed)and subscribed before me bymeans of I—physical presence or_oni ine notarization] this day of _ Al#'jl / •vmv- by � n �tArs�/l.s Personally known: OR Pro uced Identification /\ (Print name ofperson making statement) 01 Type of/dentification produced Signature of Notary public-State of Florida ,,60 Notary Public State of Flonde Christian D Gowan or w� My Commission GG 913234 Expirm 09115MO23 FOR OFFICE USE ONLY Copy of Florida Driver's License provided for Item(5) v' Other documentation 'r` rP 1 S © Provided for Item(5) Revised 03/23/2021 I APR 01202 CITY OF"INIT F' SPRINGS OFFICE OF THE CITY CLERK Florida , � %O..,. 'SA 144 E stt>a8C+ ''DR Y FI?EFl Fl.32708-4416 40"— SABRINA KATHERINE PARSONS o lig 1049 CHOKECHERRY DR WINTER SPRINGS 059 (4 AA r/26/1981 WS 2 New Covenant Church 800 Tuskawiila Road 2 Winter Springs FL 32708 s. 2s 9 Marl1D12020 107870542 Oct12912002 7 CITY OF WINTER SPRINGS 2021 MAYOR APPOINTMENT APR 41 2021 CITY OF WINTER SPRING:: OATH OF CANDIDATE OFFICE OF THE CITY CLERK "All persaw who nowor hereafter are employed byor who nowor hemfterare on the payroll of the state,or anyofrts depar&mnts and agende4 subdivisions,counties citie4 school boards and districts of the free publicschoolsystem ofthe state orcounties orinstihWons ofhigherleaming,and all candidates forpublr'c office,are required to take an oath before anyperson dulyauthorized to take adowMedgementsofinsoumentsforpublicrecord in the state"[87605(?)Flarlda Statutes] "Anyperson seeldng to qualifyfor public office who fails orreAises to file the oath required bythis act shallbe held to have failed to qualWasa candidate forpub(k offm and the name ofsuch person shall not be printed on the ballot as a qualified candidate:"[876071-7orida Statutes] 1, C , a citizen of the State of Florida and of the United States of America, and a candidate for public office, do hereby solemnly swear or affirm that I will support the Constit ion of the U 'ted States and of the State of Florida. Signature of Appointee OL Street Address R 33:7 up, city State Zip Code STATE OF FLORIDA COUNTY OF �fMiOZIP Sworn to (or affirmed) and subscribed before mel means of I_physical presence or_onlline not rization)this day of r. ,2021 by ram an.� Personally known_OR Produced Identification Type of Identification produced d . r,✓ (S 2.I"r i~- -- Notary public State of Florda Christian Q Gowan My Commission GG 913234 � Signature of Notary Public -State of Florida ►00V6 Expires 08115/2023 CITY OF WINTER SPRINGS F_c"E 9V F- 2021 2021 MAYOR APPOINTMENT APR 01 2021 nspmwas O��T�| ��F�C�k����I[�AT�� cn,nr'*mrswT,o�ca^ o�p`�sop��� OFFICE OF THE MAYOR "Each candidate,whether a party candidate,a candidate with no party affiliation,or a write-in candidate,in order to qualify for nomination or election to any office other than a judicial office as defined in chapter 10S,shall take and subscribe to an oath or affirmation in writing. Aprinted copy uf the oath or affirmation shall be furnished to the candidate by the officer before whom such candidate seeks toqua|ify—''[99D2l (1)(o) Florida Statutes] STATE OFFLORIDA ' COUNTY OF "Before me,an officer authorized to administer oaths,personally appeared (Please Print Name AaYou Wish Itn,Appear mCity Records For This Appointment) to me well known,who,being sworn,says that he or she is a candidate for the office of Mayor;that he or she is a qualified elector of the City of Winter Springs,Seminole County,Florida;that he or she is qualified under the Constitution and the laws of Florida to hold the office to which he or she desires to benominated orelected;that heorshe has taken the oath required byss.876.05-876.10,Florida Statutes;that he or she has qualified for no other public office in the state,the term of which office or any part thereof runs concurrent with that of the office he or she seeks;and that he or she has resigned from any office from which he or she is required to resign pursuant to s.99.012,Florida Statutes." \5�re of Appointee Vr,lwc� Clhb�Pcklerr�4 Street Address City State Zip Code Sworn toand subscribed before me thisday of 2021,at Seminole County, Florida. ' (Signature and Title ufOfficer Administering Oath) REIGENVLLA APR 01 2021 OFFICE OP -`NE rCITV CL.FRk ?, NOM I NATION PETITION l 'Aflinformation on this form becomes a public record upon receipt by the supervisor ofElections THIS COMPLETED ,ais a crime to knowinglysign more than one petition for a candidate.[Section 704.785 Florida Statutes) FORM MUST BE *!fall requested information on this form is not completed,the form will not be valid as a Candidate Petition Form. PROVIDED TO THE 1 d4- L 5+l" the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter informat n card) LATER THAN NOON voter of the City of Winter Springs,nominate (` Inc \d�SC�trr � ON THURSDAY, io complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. APRIL 1,2021 Date of Birth OR Voter Registration Number Address (MM/DD" Gity [ounI [t.te I Zip Code Signature of Voter Date Signed(MM/DDAYW) ITo be completed by Voter) 03 /-50/ Rule 15-2.045,FAC. NOM I NATION PETITION *AN information on this form becomes a public record upon receipt by the Supervisor of Elections THIS COMPLETED *it is a crime to knowinglysign more than one petition fora candidate.(Section 70AI85 Florida Statutes] */fallrequestedinformation onthis form Isnot completed,theform"InotbevaildasaCandidate Petition Form. FORM MUST BE 1� PROVIDED TO THE [ CA � ���ICfL the undersigned, aregistered CITY CLERK NO (Please print name as it appears on Vour v teri ation card) LATER THAN NOON voter of the City of Winter Springs,nominate �kJrIno W50v �J ON THURSDAY, o complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. APRIL 1,2021 Date of Birth OR Voter Registration Number Address �t � I� City _ [ountytate Zip Code Signature at Voter 'Date Signed(MM/DD/VYYY) [To be cod by Voter] yt'f4-\ . b� 07361 �Z'-I Rule 152.045,RAC. NOM I NATION PETITION *AllinformationonthisformbecomesapublicrecorduponreceiptbytheSupervisorofE{actions THIS COMPLETED *It is crime to knowinglysign more than one petition fora candidate.[Section 704.785F1orlda Statutes) *ffafl requested information on this form is not completed,the form willnotbe vaildas a Candidate Petition Form. FORM MUST BE PROVIDED TO THE [ the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominate `Jaj' rtr-vo %rs6V�^7 ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address (MM/DDMNY) � City � a. (Coin ' I tate Zip Code wn'l-e - c� I � f-L I 317° Signature of Voter Date Signed(MMJDD/YYYY) [To be completed by Voter] j 3p 2a 2-1 Rue 1S-2.045,F.A.C. APR 012021 CITY OF WNTER R TY CLERK OFFICE 0,- NOMINATION PETITION .All information on this Form becomes a Public record upon receipt by the SgpetWwrofEl-tions, THIS COMPLETED it is a crime to knowingly sign more than one petition for a candidate.f5ection 704.185FIOrida Statutes) FORM MUST BE 'Ifaffre ested information on this form Is not completed, h m wynotbe validasa Candidate Petition Form. 'R the PROVIDED TO THE L -,L/"— & the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter Information card) LATER THAN NOON voter of the City of Winter Springs,nominate ON THURSDAY, o complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. APRIL 1,2021 Date of Birth OR Voter Registration Number Address (MM/DDN" City [ountyra Ate [z-Ip code rL 1,S2-709�r :S of-I I Signature of voter Date Signed(MMIDDAWY) (To be completed by Voter) 3 /31 lRul.7f-2.045,F.A.C. q NOMINATION PETITION ea Allinformation an this form becomes a public record upon receipt bythe 5d pervi$or ofElecTions THIS COMPLETED *It is a crime to knowinglYSign more than one petition for a candidate.[Section W.785 Florida Statutes] FORM MUST BE 11fall requested information on this form Isnot completed,the form will not be vaildasa Candidate petition Form. PROVIDED TO THE 41,IA7Z5 " 4"Z the undersigned, a registered CITY CLERK NO (P(ease print name as it appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominate '5 obf-i act V'boy' ON THURSDAY, to complete the unexpired term of office of Mayor of Winter Springs recently vacated by former Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address (MM/Do" �4 city ountyIstate 2"ip Code Signature of Voter e Signed fM ITODat be completed by Voter) Rule IS-2.045.F.A.C. APR 0 12021 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK NOMINATION PETITION winformation on this form becomes a public record upon receipt by the Supervisor ofElections THIS COMPLETED It is a crime to knowinglysign more than one petition fora candidate.(Section 704.785 Florida Statutes) FORM MUST BE ffa#requested information on this form is not completed,theform willnotbe vaildasa Candidate Petition Form. PROVIDED TO THE 1, IlAy 4z C—z the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominate 04106Y-10, ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. APRIL 1,2021 Date of Birth OR Voter Registration Number Address (MM/DD" 1,Di C4 r /000101 tJ City [ounty tate Zip Code Signature of Voter Date signed(MWDDA^Y'YY) [To be completed by Voter] '3P/ Pule 1S-2,045,FAC. A NOMINATION PETITION *All information on this form becomes a public record upon receipt by the Supervisor of Elections THIS COMPLETED *It is a crime to knowinglysign more than one petition for a candidate.[Section 704.785FIorida Statutes] -ff all requested information on this form is not completed,theform will not be valldas a Canoida te Petition Form- FORM MUST BE PROVIDED TO THE P, the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter information card) , LATER THAN NOON voter of the City of Winter Springs,nominate '--IA i ?3movy-5 ON THURSDAY, ID(--Y1-a to complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address (MM/DD -z -7 1-7t IF% Cit [ounty tate [Zip code 13270 IF 1 ature Voter Date Signed(MM/DD/YYYY) [To be co pleted by loter] .373�11 2-02-1 Pule 1S-2.045,F.A.C. APR 012021 CITY OF WINTER SPRINGS ()FFlc=-OF THE CITY(;L-ERK NOMINATION PETITION *Allinfoimation on this form becomes a public record upon receipt by the Supervisor ofElections THIS COMPLETED *It is a crime to knowinglysign more than one petition fora candidate.[Section 704.785Florida Statutes] FORM MUST B E *7fall requested information on this form is not completed,the form KV11 not be vaildas a Candidate Petition Form. PROVIDED TO THE I, trJl�t�t h6Vw°-G-1--- the undersigned, aregistered CITY CLERK NO (Please print name as it appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominatebr'�r1ctlf Ste) ON THURSDAY, o complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. APRIL 1,2021 Date of Birth OR Voter Registration Number Address (MM/DD/YYYY) City [ounty I tate I Zip Code Signature of Voter Date Signed(M DD ) [ro be completed by Voter) Rule ls-2.045, NOMINATION PETITION *AllinformationonthlsformbecomesapublicrecorduponreceiptbytheSupervisorofElections THIS COMPLETED *!t is a crime to knowinglysign more than one petition for a candidate.[Section 704.785Ftorida Statutes] *!f equestedrnformationonthisfoimlsnotcompleted,theformwilinotbevaildasaCandidatePetitionForm. FORM MUST BE I,�g2n c� z_— the undersigned, a registered PROVIDED K THE (Please print name as it appears on your voter information card) CITY CLERK voter of the City of Winter Springs,nominate LATER THAN NOON �b�anc3 2>Yf< ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address (MM/DD b(o � GJ�� ,�(11 1Cr 'C'ty jj�unty ate Zip Code IlSimature of Voter Date Signed(MM/DD///YYYY))) ITot,P b Voter, 1 v Rule 1S-2.045,F.A.C. APR 01 2021 CITY OF WINTER SPRINGS OFFICE OP T i-tE"t"ry CLERK NOMINATION PETITION .Allinformation on this form becomes a public record upon receipt bYthOSUPel"v1sarofElecrions THIS COMPLETED 'it is crime taknowinglYsign m—than one petition fora candidate,[Section 704165F10riJaStatutes] FORM MUST BE .1fall regltrest dinform this form is not completed, in will not be vaWasa candidate Petition Form, PROVIDED TO THE I, i4awd, a registered CITY CLERK NO buEs (Please print name as it appears on your voter intormatior?'card) LATER THAN NOON voter of the City of Winter Springs,nominate ON THURSDAY, o complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. APRIL 1,2021 Date of Birth OR Voter Registration Number Address (MM/DDANYY) City rounty Z,o ode t /A L001? /A 1 5 SignatMer Date Signed(MM/DF1NYYY) 171-0 be comps ed by V0,01 1Rule lS-2.04S,FAC. NOMINATION PETITION 'A#information on this form becomes a Public record upon receipt by the Supervisor ofEfectibns THIS COMPLETED 'It is crime toknowinglYsignmore than one petition for a candidate,[section 104.185FIodda Statutes] FORM MUST BE frallrequested information on this form Isnot completed,the form willnotbe vaildasa Candidate Petition Form. PROVIDED TO THE 'A T the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominate %)Or Y-)Cc ?ar 5 ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor APRIL 1,2021 Lacey. Date of Birth OR Vote/Registration mber Address (MMIDDhyn— ILTc) City ty tate Zip Code Date Signed(MM/DDTY� Signature ot [To be completed by Voter) A-11C 4Za-d 1, Rule IS-2,045,F.A.C. P- D APR 0 12021 CITY OF WINTER SPRINGS OF;=I(-F—cDF 7H( CITY CLERK NOMINATION PETITION 'Ab information on this form becomes a public record upon receipt by the Supervisor of Elections THIS COMPLETED *It is a crime to knowinglysign more than one petition for a candidate,[Section 704.785FIorida Statutes] FORM MUST BE if all requested information on this form is not completed,the form w I not be vaild as a Candidate Petition Form. PROVIDED TO THE I, lmpp V J k c the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter information card) } LATER THAN NOON voter of the City of Winter Springs,nominateabr N'")G� Y Y� CXi �} ON THURSDAY, o complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. APRIL 1,2021 Date of Birth OR Voter Registration Number Address (MM/DD/YYYY) ?=JVr Cit ounty tate Zip Code Yom('` _ ('\�cfr) Signature of V. r Date Signed(MM/DD") rro be completed by Voter] Rule 152.045,R kC. } NOMINATION PETITION 'AllinformationonthisformbecomesapublicrecorduponreceiptbytheSupervisorofElection THIS COMPLETED 'It is a crime to knowingysign more than one petition fora candidate.[Section 704.785Florida Statutes] "Ifall requested information on this form is no eo l6ted,dhe form will not be vaild as a Candidate Petition Form. FORM MUST BE f j�� ( "l V t the undersigned, a registered PROVIDED TO THE CITY CLERK NO (Please print name as it appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominate Sb-ln-a Mon 3 ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address {MMIDDIYYYY) � p �y City/ ,` t [ounty tate Zip Code Signature of Voter Date Signed(MM/DD/YYYY) [To be completed by Voter) Rule 15- ,F.A.C. pp, F%.� APR 01 2021 CITY OF WINTER SPRINGS OFFICE OF-1"F CITY CLERK �I NOM I NATION PETITION 'Alt information on this form becomes a public record upon receipt by theSupervisorofElections THIS COMPLETED 'It is a crime to knowinglysign more than one petition fora candidate.[Section 704.785FIorida Statutes) FORM MUST BE 'Ifali requested information on this form is not completed,the form will not be vaild as a Candidate Petition Form. PROVIDED TO THE I, V0A the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominate ')ab- ?a r-5 On 5 ON THURSDAY, o complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. APRIL 1,2021 Date of Birth OR Voter Registration Number Address (MMJDDJYYYY] 0 a,5 V �G/ city ounty tate Zip Code fig-)r�eir ���n [��,r,r-t►c3���' I � �1 �'� Signature of Voter Date Signed(MM/DD/YYW) (To be completed by Voter] C3 1 , Rule 1#14S,F.A.C. NOMINATION PETITION 'All information on this form becomes a public record upon receipt by the Supervisor of Elections THIS COMPLETED 11t is a crime to knowinglysign more than one petition for a candidate.[Section 704.785 Florida Statutes] '(fall requested information on this form is not completed,theform willnotbevaildasa Candidate Petition Form. FORM MUST BE the undersigned, a registered PROVIDED TO THE CITY CLERK NO (Ple se print name as it appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominate ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recentlyvacated byformer Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address (MM/DD" City [ounty I tate I Zip Code t AIzc Sigryfit4e of Voter Date Signed(MM/DDNYYY) [To be completed by Voter Anj g' v �1 Z { Rule 1S-2.045,F. .C. APR 01 2021 CITY OF 1MNTER SPRINGS OFFICE OF THE CITY CLERK �T NOM I NATION PETITION `All information on this form becomes a public record upon receipt by the Supervisor of Elections THIS CO PLETED It is a crime to knowingly sign more than one petition for a candidate.[Section 704.785 Florida Statutes] FORM MUST BE 'Ifall requested information on this form is not completed,the form will not be valldas a Candidate Petition Form. ��1 PROVIDED TO THE I, )C!I-1/ a "C,-y ;96�;— the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter information card) LATER THAN NOON r's voter of the City of Winter Springs,nominate r� %V-50ON THURSDAY, o complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. APRIL 1,2021 Date of Birth OR Voter Registration Number Address (MM/D /YYYYj r �j 7. ip Code City rd J C. rou 1 +moi 0 ! I rate I z signature of Voter i g Date Signed(MM/DDA^M) [To be completed by Voter] 31-41 -:2/ Rule 1S-2. C. hkt NOMINATION PETITION .Aflinformation on this form becomes a public record upon receipt by the Supervisor of Elections THIS COMPLETED It is crime to knowingly sign more than one petition for a candidate.[Section 704.785 Florida Statutes] 'If all requested information on this form is not compleed,theformWllnotbevaildasaCandidate Petition Form. FORM MUST BE PROVIDED TO THE I, a S the undersigned, a registered CITY CLERK NO (Pleas nt name as it appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominate �)abrilei t c�r50k11,5 ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address (MM/DD" Citi n [ounty� I (State / I 2iode Signature of Voter x Date Signed(MM/DD/YYYY) [To be completed b Voter] Pule'%--2.04-5,-2.045,17 APR 01 2021 CITY OF WINTER SPRINGS OFt:ICE()Fr TNF CITY CLERK