Calling for new Community Board 6 Members: Applications Due January ONE, 2009!

Please consider serving our community by submitting a New Member Application Community for Community Board 6 to the offices of our Borough President Marty Markowitz and to our Councilman Bill DeBlasio.

The deadline is in a few short weeks! (January 1, 2009). Learn more about Community Board 6 and find this application at http://brooklyn-usa.org/Pages/Community_Board/getinvolved.htm

CB 6 covers: Red Hook, Carroll Gardens , Park Slope, Gowanus, and Cobble Hill.

If you have questions please write us at cgcord@gmail.com

""The Community Boards play an important role in improving the quality of life for all citizens of Brooklyn, but many people don't know about them. We urge you to learn how your Community Board can help you, and how you may be able to help your Community Board.

Membership
Community Boards are local representative bodies. There are 18 throughout Brooklyn . Each Board consists of up to 50 unsalaried members appointed by the Borough President, with half nominated by the City Council Members who represent the community district. Board members are selected by the Borough Presidents from among active, involved people of each community, with an effort made to assure that every neighborhood is represented. Board members must reside, work or have some other significant interest in the community.

Meetings
Boards meet once each month. At these meetings, members address items of concern to the community. Board meetings are open to the public, and a portion of each meeting is reserved for the Board to hear from members of the public. In addition, Boards regularly conduct public hearings-on the City's budget, on land use matters, and other major issues-to give the people of the community the opportunity to express their opinions" (CB 6 Website)

CB 6
250 Baltic Street,
Brooklyn, NY 11201
Phone: 718.643.3027
Fax: 718.624.8410
Email: info@brooklyncb6.org
Website: www.brooklyncb6.org

NEW MEMBERSHIP APPLICATION FOR

COMMUNITY BOARD NO. ____

NOTE TO APPLICANTS: You must be a New York City resident to serve on a community board. To qualify for a particular board, you must live, work in, or have a professional or other significant interest in that board’s district. Conflicts of Interest Board rulings require that applicants disclose whether they or their employers derive any income representing clients before the community board (i.e. attorneys, architects, consultants, etc.). These rulings do not automatically exclude one from board membership, but the information is essential.

THIS APPLICATION MUST BE NOTARIZED AND RETURNED BY MAIL. DO NOT FAX.

Please type or print clearly in ink. Do not leave any areas blank. If questions do not apply, indicate “n/a” or draw a slash through the section.

Name: _____________________________________________________________________

(Last) (First) (M.I.)

COMMUNITY INTEREST (check all that apply)

LIVE IN DISTRICT □ *WORK IN DISTRICT □ *PROFESSIONAL/SIGNIFICANT INTEREST □

* Please describe: ________________________________________________________________________________________________

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

neighborhood of interest _____________________________________________________________

Have you attended a Meeting of this community board in the past year? YES □ NO □

ARE YOU CURRENTLY SERVING (or have you previously served) as A MEMBER OF A COMMITTEE OF THIS COMMUNITY BOARD? YES □ NO □ If so, please list committee(s) _________________________________________

How many hours per month can you devote to community board activities? _______

Have you ever served on a community board? YES □ NO □

If yes, complete the information requested below. Please note if you were a public member of a board committee.

CB No. COUNTY DATES SERVED POSITION HELD COMMITTEE

______ ________ ______________________ ______________________ ______________________

______ ________ ______________________ ______________________ ______________________

______ ________ ______________________ ______________________ ______________________

aS A COMMUNITY BOARD MEMBER, YOU WILL BE EXPECTED TO SERVE ON 2 OR MORE COMMITTeES. (Committees MAY vary with each community board)

INFORMATION AS DENOTED BY (**) BELOW WILL NOT BE MADE PUBLIC

CONTACT INFORMATION

FULL NAME ____________________________________________________

**Home Address (include apt. NO.) _______________________________________________________________

City_________________ STATE ________________________ Zip_____________

**PHONE NUMBERS

Home (____) ________________________ MOBILE (____) ________________________

Work (____) ________________________ fax (____) ________________________

**EMAIL ADDRESS _________________________________________________________________________________

EMPLOYMENT INFORMATION

**Employer _______________________________________________________________________________________

**Your Title/Position _____________________________________________________________________________

**EMPLOYER Address ___________________________________ City __________ ST ______ Zip ___________

**Telephone (____) ___________________ **YEARS WITH EMPLOYER _______________

COMMUNITY/CIVIC INTERESTS

Community Activities (List all civic and community organizations, neighborhood associations and/or any other groups. Please indicate if you hold any executive positions, including board of directors.)

ORGANIZATION		DATES		TITLES		ADDRESS

PLEASE STATE WHY YOU BELIEVE YOU WOULD BE AN EFFECTIVE COMMUNITY BOARD MEMBER AND PROVIDE ANY ADDITIONAL INFORMATION YOU BELIEVE WOULD BE USEFUL IN CONSIDERING YOUR APPLICATION. (Include relevant skills, interests and/or resume.)

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

___________________________________________________________________________________________________

REFERENCES

Name _______________________________________ Address _____________________________________________________

Telephone (_____) ______________________ affiliation/Relationship ____________________________________

Name _______________________________________ Address _____________________________________________________

Telephone (_____) _______________________ affiliation/Relationship ____________________________________

Name _______________________________________ Address _____________________________________________________

Telephone (_____) _______________________ affiliation/Relationship _____________________________________

Identification and Statement

I am a U.S. citizen□ YES □ NO If no, permanent resident □ YES □ NO

I (check one) □ HAVE NEVER □ HAVE been convicted of a misdemeanor or felony. (If you have, describe and explain on a separate sheet of paper and attach it to this application.)

I am not employed by a council member whose district covers parts of this community board district, or by the Brooklyn Borough President. I am not employed by the State or City of New York in a position at or above the level of assistant commissioner or have secured a mayoral waiver allowing me to serve on a community board and have affixed a copy hereto.

I affirm that I am a New York City resident and that I am at least 18 years of age.

I HEREBY AFFIRM THAT ALL THE ABOVE INFORMATION IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE.

SIGNATURE ____________________________________ DATE _________________________

Sworn to before me this _______ day of ____________, 20_____

NOTARY PUBLIC or

COMMISSIONER

OF DEEDS _________________________________

OFFICIAL USE ONLY: COUNCIL DISTRICT: _____ DATE RECEIVED: ___/____/____ DATE INPUT: ___/____/____