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2. DAVE LOWERY

   ^MAYOR

   CHRIS LIGHTFOOT

   ^{INTERIM CITY MANAGER} 

   AMY MYERS

   ^{CITY ATTORNEY}

3. 

4. COMMISSIONERS 

   SAM PEEBLES 

   PAT PERNO 

   JAMIE WARRICK 

   JUDY TINDER

6. Applicant Information

8. First Name*
9. Last Name*
11. Address*
13. City*
14. State*
15. Zip Code*
17. Phone Number*
18. Email Address*
20. Occupation*
21. Business Phone*
23. Business Address*
25. City*
26. State*
27. Zip Code*
29. Do you live in the corporate city limits of Lynn Haven?*

    1. Yes
    2. No
30. Do you currently serve on a City Board/Committee?*

    1. Yes
    2. No
31. Do you currently hold a public office?*

    1. Yes
    2. No
32. Have you attended a meeting of the applied-for board?*

    1. Yes
    2. No
34. How many hours per week/month are you willing to spend on this activity?*
35. I will attend each meeting in accordance with the adopted policies of the City*

    1. I agree

39. Board/Committee

    Please select all Boards and Committees that you are interested in serving:

41. Planning Commission

    1. The Planning Board consists of seven members appointed by the City Commission to four-year terms and serves in an advisory role. Members may serve up to two consecutive terms. The Board coordinates the City’s planning efforts with Bay County jurisdictions, monitors the City’s Comprehensive Plan, and advises the City Commission on Comprehensive Plan amendments, development orders, land use changes, certificates of concurrency, and updates to the Unified Land Development Code.
43. Beautification Board

    1. The purpose of this board is to study, investigate, and recommend plans to the City Commission to enhance the City’s beautification and cleanliness. Its duties include promoting beautification efforts, encouraging the planting and preservation of trees, plants, and other foliage, protecting songbirds and their habitats, collaborating with local organizations on beautification initiatives, and supporting the Neighborhood Matching Grant Program.
45. Community Services Board

    1. This board advises the City Commission and Community Services Department and builds partnerships to promote youth and senior services. Duties include advising on project funding, supporting fundraising, forming partnerships with leisure and cultural organizations, exploring new programs, and promoting events, capital improvements, and Leisure Services.
47. Board of Adjustments

    1. Consists of five members who are appointed by the City Commission. Each Board Member sits for a three-year term, and may serve two consecutive terms. Duties include: Act in an advisory capacity to the City Commission and make recommendations to the City. Commission concerning the need to study, revise, or amend city codes and ordinances affecting the growth and development of the City. Authorize variances.
49. Constructions Licensing Board

    1. The purpose of this board is to examine qualifications of all persons who desire to engage in the trade of business of constructions. Duties include: Prescribe exams, Certificates of Competency, notices of violation, conduct hearings, revoke or suspend Certificates of Competency. Hear appeals of persons charged with violations by contractors or persons who may be aggrieved by the Building Official. Approve integrity of applicants. Enforce provisions of Lynn Haven Code and Building Regulations.
51. CRA Advisory Board

    1. The seven-member Board is responsible for drafting, ranking, and recommending a list of CRA specific projects for each fiscal year along with any other tasks that the Board may assign from time to time.
53. Charter Review Advisory Committee

    1. The five-member Committee is responsible for meeting, discussing, reviewing, and recommending updates to the City's Charter.
55. Infrastructure Tax Oversight Committee

    1. The five-member Board is responsible for ensuring the City's expenditure of surtax proceeds is consistent with Florida Statutes Section 212.055(2) and that the City's expenditures of proceeds is consistent with the approved project list.
57. Finance Review Committee

    1. The Finance Review Committee is an advisory body providing oversight and promoting sound fiscal management for the City of Lynn Haven. Composed of five members appointed by the City Commission, the committee reviews the budget, utility and sanitation rates, fee schedules, and assessments. It makes recommendations to support informed decisions, transparency, and long-term financial stewardship.
59. If you could choose which board or committee you preferred to serve on, which would it be? *

63. Educational Background

65. High School
66. Location
68. Years Attended (Start Year - End Year)
69. Did you graduate?

    1. Yes
    2. No
71. College
72. Location
74. Years Attended (Start Year - End Year)
75. Did you graduate?

    1. Yes
    2. No
76. Degree
78. College/Professional Organization
79. Location
81. Years Attended (Start Year - End Year)
82. Did you graduate/complete?

    1. Yes
    2. No
83. Degree/Certificate

87. References

    Please list 3 professional references.

89. Reference 1

91. Full Name*
92. Relationship*
94. Address*
96. Company*
97. Phone Number*

99. Reference 2

101. Full Name*
102. Relationship*
104. Address*
106. Comapny*
107. Phone Number*

109. Reference 3

111. Full Name*
112. Relationship*
114. Address*
116. Company*
117. Phone Number*

121. Military service

123. Branch
124. Years of Service (Start Year - End Year)
126. Rank at Discharge

130. Disclaimer and Signature

132. Check both boxes to agree:*

     1. I certify that my answers are true and complete to the best of my knowledge.
     2. If this application leads to placement on a board/committee, I understand that false or misleading information in my application or interview may result in my release.
134. Electronic Signature Agreement

     By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

     1. I agree.
136. Electronic Signature
Leave This Blank:


138. 1. Receive an email copy of this form.
139. Email address

     This field is not part of the form submission.

140. Submit

* indicates a required field