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RECEIVED <br />0 ,; 2G.J <br />INDIAN RIVER COUNTY APPLICATION <br />FOR COMMITTEE APPOINTMENT <br />BOARD 011.NTY / <br />NRea cr 4015-' )9% <br />Full Name: <br />Street Address (No P.O. Boxes): <br />Date: <br />Email Address: <br />5 <br />Home Phone /..2--717 rk Phone: <br />How long have you been a resident of Indian River County? <br />4/ <br />.3 ica.(' <br />.1216615-t'rel <br />s in V .(‘ ft...J-2101 <br />Cell Phone: <br />Are you a full or part time resident? Check one: Full TimePart Time <br />Please list current employer or business. If retired, please list any business experience that may be <br />applicable to the committee. <br />r411 o4) C 011/1 1( CO ni th)�Slch,r 3 ci c <br />Please list any licenses you presently hold: <br />e007. eRecif 674 - <br />00,57t p4b, yemx <br />Please list any organization of which you are currently a member: <br />CJi/-t<eef%n/)oh(j')VII <br />v C )1041 beAr ot-Pcoip)47 <br />-s7 L10; Cakeir4 s <br />Please list any other committees or boards you currently sit on: <br />Jim Kordiak <br />Continued on nex <br />255 I I th Sq. SW <br />Vero Beach, FL. 32962 <br />612-747-0724 <br />ikordiak@comcast.net <br />134 <br />