§ 2-159. Information required for all appointees for boards, commissions and agencies.

All appointees of a parish board, commission, or agency shall provide the following information:

Name:  _____

Address:  _____

_____

Home Phone No.: ______________ Cell Phone No.: ______________

Occupation:  _____

Committees of Interest:  _____

Years of Resident of Tangipahoa Parish:  _____

Have you served on any parish committee previously: _______Yes _______No

(If yes, what committee/s  _____ )

APPOINTEE:  _____

BOARD/COMMISSION/AGENCY:  _____

COUNCIL DISTRICT:  _____

DATE:  _____

By signing below, I certify that I the foregoing information is correct.

_____

(Ord. No. 05-25, 5-9-05)