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772-633-7748 I <br />N ame: <br />INDIAN RIVER COUNTY APPLICATION <br />FOR COMMITTEE APPOINTMENT <br />!Curtis Carpenter <br />Full Name. <br />Curtis Carpenter <br />Street Address (No P.O. Boxes): <br />H ome Phone: <br />Date: <br />01/29/14 <br />Email Address: <br />Iedapron@gmail.com <br />915 28th Avenue, Vero Beach, FL 32960 <br />Work Phone: <br />H ow long have you been a resident of Indian River County? <br />Cell Phone: <br />17 years <br />Are you a full or part time resident? Check one: Full Timers Part Time <br />Please list current employer or business. If retired, please list any business experience that may be <br />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 Department of <br />H ealth, 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 />73 <br />