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INDIAN RIVER COUNTY APPLICATION <br />FOR COMMITTEE APPOINTMENT <br />Full Name: Curtis Carpenter <br />Today's Date: 01/29/14 Email Address: Iedapron@gmail.com <br />Street Address (No P.O. Boxes): 915 28thAvenue, Vero Beach, FL 32960 <br />Home Phone: <br />Work Phone: Cell Phone: 772-633-7748 <br />How long have you been a resident of Indian River County? 17 years <br />Are you a full or part time resident? Check one: Full Time Q Part Time <br />Please list current employer or business. If retired, please list any business experience that <br />may be applicable to the committee. <br />Southern Litho <br />Please list any licenses you presently hold: <br />Certified with the American Registry of Radiologic Technologists and the Florida <br />Department Health, Radiologic Sciences. <br />Please list any organization of which you are currently a member: <br />Treasure Coast Democratic Environmental Caucus <br />Please list any other committees or boards you currently sit on: <br />N/A <br />Continued on next page <br />149 <br />