Call for BAC Alternate Members (due 1/16/08)

Per the BAC action at the December meeting, the deadline for submitting applications for Alternate membership has been extended from Wednesday, December 19 at 5:00 PM until Wednesday, January 16 at 5:00 PM. Should you or anyone you know be interested in applying, please complete and submit the attached application to Annick Beaudet or myself prior to the stated deadline.

The next BAC meeting will be held on Thursday, January 17 at 6:45 PM. An agenda will be distributed prior to the meeting, which will include an item to appoint the remaining 6 of 10 Alternate members by the full BAC.

Sincerely,
________________________________

Eric Dusza
Planner III, Bicycle & Pedestrian Program
Public Works Department | City of Austin
Phone (512) 974-6504 | Fax (512) 974-7222
eric.dusza@ci.austin.tx.us | www.cityofaustin.org

APPLICATION FOR MEMBERSHIP
CITY OF AUSTIN BICYCLE ADVISORY COUNCIL

Name: __________________________________________________________________
Address: ________________________________________________________________
City: ___________________ State: _____________________ Zip: _________________
Preferred Phone: ______________________ Other Phone: _______________________
E-mail Address: __________________________________________________________
Date of Birth: ____________________________________________________________
Occupation: ___________________ ____ Employer: ____________________________

1. Do you reside within City of Austin boundaries? 0 No 0 Yes

2. Education (Schools attended, degrees earned, training received):
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

3. Do you currently hold elective office? 0 No 0 Yes: _________________________

4. Affirmative Action information: This information is voluntary, and is being collected both for statistical reporting purposes and to assure diversity on the Bicycle Advisory Council.

0 Male 0 Female Racial/Ethnic Background: ______________________________

5. List any major paid employment and volunteer activities, which may relate to service on the Bicycle Advisory Council: Dates (from/to) Employer/Volunteer Activities Responsibilities
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

6. Do you have any special skills or experience that will help you as a member of the Bicycle Advisory Council?
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

7. Why do you want to serve on the Bicycle Advisory Council?
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

8. List names, addresses, and phone numbers of two people who may be contacted as references:
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

9. Describe your bicycle use (check all that applies):

-- I bike for transportation year-round

-- I bike for transportation in good weather

-- I am a regular recreational rider

-- I occasionally ride for fun and/or exercise

-- I bike with my family

-- I seldom ride my bike

-- Other: ___________________________________________________________

10. Additional comments:
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________