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2. Last Name*
3. First Name*
4. District # You Live In.*
6. Home Address*
7. City*
8. State*
9. Zip Code*
11. Home Phone
12. Cell Phone
13. Email Address*
15. Owner or Renter *
16. Number of years as city resident*
17. Are you registered to vote in Broward County?*
    -- Select One --YesNo
18. Education (highest degree / level)
20. Occupation*
21. Work Phone
23. Business Name*
25. Business Address
26. City
27. State
28. Zip Code
30. Identify the board / committee(s) to which you request appointment (Please rank in order of preference)
32. Selection (1)*
    -- Select One --Affordable Housing Advisory CommitteeAfrican American Advisory CouncilArtwork Selection CommitteeCivil Service BoardCommunity Development Advisory BoardEducation Advisory CommitteeEmployees' Retirement PlanFirefighters’ Pension BoardGeneral Obligation Bond Oversight Advisory CommitteeHistoric Preservation BoardHollywood Centennial Celebration CommitteeHollywood Housing AuthorityMarine Advisory BoardParks, Recreation & Cultural Arts Advisory BoardPlanning & Development BoardPolice Officers’ Pension BoardSustainability Advisory CommitteeYoung Circle ArtsPark Advisory Board
33. Selection (2)*
    -- Select One --NoneAffordable Housing Advisory CommitteeAfrican American Advisory CouncilArtwork Selection CommitteeCivil Service BoardCommunity Development Advisory BoardEducation Advisory CommitteeEmployees' Retirement PlanFirefighters’ Pension BoardGeneral Obligation Bond Oversight Advisory CommitteeHistoric Preservation BoardHollywood Centennial Celebration CommitteeHollywood Housing AuthorityMarine Advisory BoardParks, Recreation & Cultural Arts Advisory BoardPlanning & Development BoardPolice Officers’ Pension BoardSustainability Advisory CommitteeYoung Circle ArtsPark Advisory Board
35. Selection (3)*
    -- Select One --NoneAffordable Housing Advisory CommitteeAfrican American Advisory CouncilArtwork Selection CommitteeCivil Service BoardCommunity Development Advisory BoardEducation Advisory CommitteeEmployees' Retirement PlanFirefighters’ Pension BoardGeneral Obligation Bond Oversight Advisory CommitteeHistoric Preservation BoardHollywood Centennial Celebration CommitteeHollywood Housing AuthorityMarine Advisory BoardParks, Recreation & Cultural Arts Advisory BoardPlanning & Development BoardPolice Officers’ Pension BoardSustainability Advisory CommitteeYoung Circle ArtsPark Advisory Board
36. Selection (4)*
    -- Select One --NoneAffordable Housing Advisory CommitteeAfrican American Advisory CouncilArtwork Selection CommitteeCivil Service BoardCommunity Development Advisory BoardEducation Advisory CommitteeEmployees' Retirement PlanFirefighters’ Pension BoardGeneral Obligation Bond Oversight Advisory CommitteeHistoric Preservation BoardHollywood Centennial Celebration CommitteeHollywood Housing AuthorityMarine Advisory BoardParks, Recreation & Cultural Arts Advisory BoardPlanning & Development BoardPolice Officers’ Pension BoardSustainability Advisory CommitteeYoung Circle ArtsPark Advisory Board
40. Affordable Housing Advisory Committee - Questions*
    Please answer these five questions above. 1. In your opinion what is the greatest challenge to keeping housing affordable in Hollywood? 2. Which of the following disciplines are you most skilled? • Home Purchase Education, • Housing Market Employment. • Housing Market Stability. • Affordable Housing Construction. * Affordable Housing Activism. 3. Which of the following disciplines are you most passionate? • Ownership Housing Affordability, • Rental Housing Affordability, • Housing Market Stability, • New Housing Construction, * Fair Housing. 4. What (if any) life experience motivated you toward volunteerism? 5. What role does housing diversity play in Hollywood’s economic health?
42. African American Advisory Council - Questions*
    Please answer these five questions above. 1. What is the greatest challenge facing the African American Community in Hollywood? 2. How many hours per month can you dedicate to AAAC initiatives? 3. Which of the following disciplines are you most skilled? * Education, * Employment, * Economics, * Cultural Awareness, * Housing. 4. Which of the following disciplines are you most passionate? * Education, * Employment, * Economics, * Cultural Awareness, * Housing. 5. What (if any) life experience motivated you toward volunteerism?
44. Artwork Selection Committee - Questions*
    Please answer these five questions above. 1. What are your primary interest in City Government and City Services? 2. Why do you want to join the Artwork Selection Committee? 3. What other relevant organizations, clubs, or associations were you previously, and/or currently are involved in? 4. Are you available to attend regular committee board meetings scheduled for the Second Monday each month at 5:30pm? 5. What is your one area of highest interest related to the Arts within the City of Hollywood?
46. Civil Service Board - Questions*
    Please answer these five questions above. 1. Describe your involvement with establishing, reviewing and interpreting policies and procedures? 2. Describe your involvement in employment practices including interviewing, testing, hiring, selection and promotion, demotions, transfers, etc. 3. Describe your knowledge of Civil Service and its purpose. 4. Why do you want to serve on this Civil Service Board? 5. Are you a continuous resident of and continuous registered elector in the City of Hollywood?
48. Community Development Advisory Board - Questions*
    Please answer these five questions above. 1. Do you reside in a low and moderate income (LMI) neighborhood in Hollywood per the most recent US Census data? A Hollywood LMI Map is located at www.hollywoodfl.org on the Community and Economic Development webpage. 2. What Community Development issues do you believe are the most important to Hollywood? 3. What is your definition of a healthy neighborhood? 4. What do you believe is the vision and primary work of the Community Development Advisory Board? 5. What do you believe uniquely qualifies you to serve on the Community Development Advisory Board?
50. Education Advisory Committee - Questions*
    Please answer these five questions above. 1. What are the current challenges facing education? 2. What is your vision for education in Hollywood? 3. What do you see as the primary work of the Education Advisory Committee? 4. With only one meeting a month, the Committee is limited in what it can do. How does/should the Committee decide what’s most important? 5. How can the Committee know if its mission and goals are being accomplished?
52. Employees' Retirement Plan - Questions*

    Please answer these five questions above. 1. Are you familiar with the State's Sunshine Laws (Chapter 119 of the Florida Statutes)? 2. Are you available to attend in person regular monthly Board meeting (typically held the 4th Tuesday of each month)? 3. What knowledge, skills and/or abilities will you bring to the Employees' Retirement Plan? 4. What do you believe are the responsibilities of a trustee on a municipal retirement plan board? 5. Are you familiar with municipal defined benefit retirement plans and/or have previous experience serving on a municipal retirement plan board?

54. Firefighters' Pension Board - Questions*
    Please answer these five questions above. 1. What knowledge, skills and abilities would you bring to the meetings? 2. What experience do you have with firefighter pensions? 3 What is your financial background? 4. How many years have you lived in Hollywood? 5 How familiar are you with local retirement systems?
56. General Obligation Bond Oversight Advisory Committee - Questions*

    Please answer these four questions above. Why do you want to join the GO Bond Oversight Advisory Committee? 2. Explain how your personal and/or professional experiences will contribute to the meeting the goal(s) of the Board or City. 3. Which Bond interests you the most? Public Safety? Parks/Golf/Open Space or Neighborhoods & Resiliency? 4. What is your perspective on city quality of life, healthy neighborhoods, economic development & a strong tax base?

58. Historic Preservation Board - Questions*
    Please answer these five questions above. 1. How have you prepared yourself to serve on the Historic Preservation Board? 2. Explain how your personal and/or professional experiences will contribute to the meeting the goal(s) of the Board or City. * Personal experiences, * Professional experiences. 3. What is your perspective on balancing growth of the City’s tax base, within the Historic Districts, while maintaining neighborhood stabilization? 4. How would you balance historic architecture with modern architectural styles? 5. What do you like about the City’s different Historic Districts?
60. Hollywood Centennial Celebration Committee*

    Please answer these five questions above.  1. What is your primary interest in serving on the Committee?  2. What is your financial/accounting background?  3. What knowledge, skills and abilities would you bring to the meetings?  4. What other organizations and/or associations were you previously, and/or currently involved with?  5. Are you available to attend regular committee meetings?  (dates to be determined by all members)

62. Hollywood Housing Authority - Questions*
    Please answer these five questions above. 1. In your opinion what is the greatest challenge to keeping housing affordable in Hollywood? 2. Which of the following disciplines are you most skilled? * Property Management, * Affordable Housing Administration, * Housing Market Stability, * Affordable Housing Construction, * Affordable Housing Activism. 3. Which of the following disciplines are you most passionate? * Property Management, * Rental Housing Affordability, * Housing Market Stability, * New Housing Construction, * Fair Housing. 4. What (if any) life experience motivated you toward volunteerism? 5.What role does housing diversity play in Hollywood’s economic health?
64. Marine Advisory Board - Questions*
    Please answer these five questions above. 1. What is your involvement with the City of Hollywood’s Waterways? 2. What will guide your decisions on this board? 3. Are you able to dedicate 2-3 hours a month to attend the meetings? Attendance is paramount to this Board being able to get things done. 4. Are you currently or have you been a boater, marine industry professional or involved in any other marine related industry? 5. What is your vision for the city of Hollywood’s Waterway system?
66. Parks, Recreation & Cultural Arts Advisory Board - Questions*
    Please answer these six questions above. 1. How many events have you attended in the past year at any of the parks and athletics facilities in the City? 2. How many City-sponsored special events have you attended for the past year? 3. Are you available to attend regular Board meetings? Regular meetings are on the 1st Thursday of the month for 8 months per calendar year. 4. What is your one area of highest interest related to the parks, recreation and cultural arts for the City? 5. What other relevant organizations, clubs, or associations were you previously, and/or currently are involved in? 6. How does parks, recreation and cultural arts contribute to quality of life?
68. Planning & Development Board - Questions*
    Please answer these five questions above. 1. How have you prepared yourself to serve on the Planning and Development Board? 2. Explain how your personal and/or professional experiences will contribute to the meeting the goal(s) of the Board or City. * Personal experiences, * Professional experiences. 3. What is your perspective on balancing growth of the City’s tax base while maintaining neighborhood stabilization? 4. What recent developments within the City are most proud of? 5. What is a Comprehensive Plan?
70. Police Officer's Pension Board - Questions*
    Please answer these five questions above. 1. What is a fiduciary? And what is your responsibility to the police pension plan as a fiduciary? 2. What is the Sunshine Law? 3. What is Asset Allocation & Diversification? 4. Explain the history of Chapter 99-1 and Chapter 185? 5. Define the role of the Actuary and the Auditor?
72. Sustainability Advisory Committee - Questions*
    Please answer these five questions above. 1. Why do you want to join the committee? 2. Have you attended any committee meetings? If so, how many? 3. What knowledge, skills, and abilities would you bring to the committee if appointed? 4. What other organizations, clubs, or associations are you involved in? 5. Are you available to attend regular committee and subcommittee meetings? Regular meetings are held monthly with subcommittee meetings held as needed. 6. What types of projects would you like to see the committee work on?
76. Young Circle ArtsPark Advisory Board - Questions*
    Please answer these five questions above. 1. What are your primary interest in City Government and City Services? 2. How many ArtsPark events have you attended within the past year? 3. What other relevant organizations, clubs, or associations were you previously, and/or currently are involved in? 4. Are you available to attend regular committee board meetings scheduled for the Second Tuesday each month at 5:30 pm? 5. What is your one area of highest interest related to the ArtsPark at Young Circle?
78. Are you interested in serving on more than one board/committee?*
    -- Select One --YesNo
79. If so, how many?*
    -- Select One --01234
80. Applicant must attend at least one board/committee meeting prior to consideration of application for every board applied. Please list board/committee meetings you attended in the last year?*
82. Are you currently on a County or City Board?*
    -- Select One --YesNo
83. If yes, please describe
85. If you are applying for a board / committee, which has specific requirements / categories, please detail how your background and/or experience meets the required criteria.*
87. Please describe your professional and/or volunteer experience or background, which best qualifies you for selection to the board / committee.*
89. Are you presently employed by the City of Hollywood?*
    -- Select One --YesNo
90. If so, in what capacity?*
92. Attach Resume (only .doc and .pdf files)*
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94. 1. Receive an email copy of this form.
95. Email address

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96. Submit

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