2. 
4. Application for Consideration of Appointment - Food Service Advisory Board
6. The Public Information Act (PIA) may allow for public review of this application upon request
   
   
   Qualifications for the Food Service Advisory Board:
   Shall be composed of local certified food managers from the food service or food processing industry, any member of the local restaurant association who owns or conducts business in the City of Kerrville or any citizen of Kerr County qualified by training and/or experience to advise on the application of the food code.
   
   Powers and Duties:
   To hear appeals and make recommendations to the health official for variances from provisions of the code; to provide assistance to the health official concerning interpretations of the code; to advise the city manager, at his request, regarding the suspension or revocation of food permits; and to consider and make recommendations to city council regarding any matters relating to the food service program.
   
   Term of Office: Two years, maximum of two consecutive terms
   Number of Members: Seven
   Meeting Time & Place: Quarterly, third Tuesday, 3:00 p.m., Development Services Office
   Established by: Ordinance 1989-30; amended by Ordinance 1994-11
   Code of Ordinances: Chapter 58 – Article II – Section 58-34
   Council Interview Team: Place One and Place Three
   
   A public notice will be announced to accept applications no less than 30 days prior to the date of regular board appointments, and no less than 14 days in the case of a vacancy.
8. Is this a New Application or a Re-appoinment Application?*

   1. New Application
   2. Re-appointment Application
10. Personal Information
12. Personal Information*

    1. Mr.
    2. Dr.
    3. Ms.
    4. Mrs.
    5. Other
14. First Name*
15. Last Name*
17. Address:*
19. City*
20. State*
21. Zip*
23. Mailing Address: (if different)
25. City
26. State
27. Zip
29. Phone Number (Home)*
30. Phone Number (Business)
32. Fax Number (Home)
33. Fax Number (Business)
35. Email Address*
37. Are you a qualified voter in the city of Kerrville? *

    1. Yes
    2. No
39. Do you live inside the city limits of Kerrville? *

    1. Yes
    2. No
41. How Long?
43. Employment
45. Employer Name:*
47. Employer Address:
49. Occupation:
51. Business Address:
53. City
54. State
55. Zip
57. To the best of your knowledge, are you employed by, or a member of, any entity (business or non-profit) with proposals, programs, requests, businesses, applications, licenses or any other matters which may come before a board or commission for review, funding, support, or approval during the next two years?

    1. Yes
    2. No
59. If yes, please list the name of entity and interest:
61. Education and Experience
63. List most advanced degree received:
65. School:
66. Year:
68. Volunteer Experience/Community Service:
70. Please specify membership on any other governmental body in another jurisdiction:
72. Have you been a member of a City of Kerrville commission, board or committee? *

    1. Yes
    2. No
74. If yes, please specify Board/Commission & Dates of Service
76. Please specify membership on any other governmental body in another jurisdiction:
78. To the best of your knowledge, are you employed by, or a member of, any entity (business or non-profit) with proposals, programs, requests, businesses, applications, licenses or any other matters which may come before this board for review, funding, support, or approval during the next two years?*

    1. Yes
    2. No
80. If yes, list entity and interest:
82. What experiences qualify you to serve on the Food Service Advisory Board?*
84. In your opinion, what are the three most pressing issues facing the Food Service Advisory Board?*
86. What do you hope to accomplish by serving?*
88. Please provide any additional information you believe would be useful in considering your application. *
90. Certification*

    I am not employed by the City of Kerrville. If appointed, I will notify the City of Kerrville of any changes in my residence or business, or of any other relevant changes that would affect my appointment. I will also notify the City if any potential conflicts of interest arise. I recognize that my appointment requires my regular attendance and participation at all scheduled meetings. Failure to do so may result in my removal. I am willing to make this commitment of time and effort. I understand and acknowledge that by selecting the 'I Agree' option below, I hereby certify that all information in this application is complete, truthful and accurate to the best of my knowledge.

    1. I agree
    2. I do not agree
92. First Name
93. Last Name
95. Date
    Date
97. Note:
    When filed at city hall, this will become a public document that may be disclosed per the Texas Public Information Act.
Leave This Blank:


99. 1. Receive an email copy of this form.
100. Email address

     This field is not part of the form submission.

101. Submit Submit and Print

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