HomeMy WebLinkAbout2024 05 18 Weisman, Leah ApplicationSubmit Date: May 18, 2024 First Name Middle Initial Last Name Home Address City State Postal Code Email Address Primary Phone Alternate Phone City of Winter Springs, FL Boards & Commissions Application Form Public Records Profile What district do you live in? District 5 Which Boards would you like to apply for? Bicycle and Pedestrian Advisory Committee: Submitted 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? 29 years Leah R Weisman 113 Brookshire Ct Winter Springs FL 32708 mactrix1@me.com Home: (407) 782-5730 Home: (407) 782-5730 Leah R Weisman 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 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 Interest & Experiences Why are you interested in serving on a board or committee? I would like to assist in the continuing development of the park system to the enjoyment of all our residents. Briefly state any specialized knowledge or prior experience you have that would be useful in assisting the board or committee in accomplishing its purpose. Friends of Leash Optional Parks Treasurer Teacher of students with special needs. Briefly state any experience you have in serving on any governmental board or committee. Winter Springs Code enforcement Financial Disclosure Requirement Leah R Weisman Date of Birth State Reporting Requirements Ethnicity * Caucasian/Non-Hispanic Gender * Female Do you have a physical disability? Yes No 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 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 Acknowledgment Please Agree with the Above You agree that you have read and understood the above and further agree to comply with noted requirements. I Agree 10/11/1961 Leah R Weisman