FOR IMMEDIATE RELEASE
April 3, 2019
Kevin Keller, Public Information Officer 508 South 2
nd
Street
kkeller@copperascovetx.gov Copperas Cove, Texas
Fax: (254)542-8965 Phone: (254)547-4221
Keep Copperas Cove Beautiful Commission
Copperas Cove, Texas The City of Copperas Cove is accepting applications to fill positions
on the Keep Copperas Cove Beautiful Commission. The purpose of the City Council
Appointed Advisory Body is to develop and recommend policies related to litter prevention,
beautification, and community improvement. The advisory body consists of fifteen members,
appointed to three year terms each, and meets monthly on the first Monday.
Applications are available at 914 South Main Street, Suite B, or on the City website,
www.copperascovetx.gov under “Forms and Applications”. The position vacancies will be
advertised through May 3, 2019. Completed applications must be submitted to the office of
the City Secretary by the submittal deadline, May 13, 2019 at 5pm, for consideration.
For further information please contact City Secretary Lisa Wilson at
lwilson@copperascovetx.gov or (254)547-4221.
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City Council Appointed Advisory Body Application
Advisory Body Preference 1: ____________________________________________________________________
Advisory Body Preference 2: ____________________________________________________________________
Full Name: ____________________________________________________________ City Resident: _____ years
Residential Address: __________________________________________________________________________
Primary Phone: __________________ Mobile Phone: _________________ Date of Birth: __________________
Driver’s License State/Number: ____________________ Personal Email: ________________________________
Business Name: ______________________________________________________________________________
Business Address: ____________________________________________________________________________
Business Phone: ________________________ Business Email: ________________________________________
Experience or special knowledge applicable to the Copperas Cove Advisory Body function:
Civic Activities and/or Professional Affiliations:
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Are you currently or have you ever been party to any misdemeanor or felony criminal matter (other than minor
traffic violations for which no arrest was made), in which you were charged, convicted, fined, served probation,
participated in deferred adjudication or other program to avoid conviction, or made restitution or participated in
pre-trial diversion or other program to avoid prosecution? (Conviction will not automatically disqualify applicant)
No: _____ Yes: _____ If yes, please explain:
NOTE: Please carefully read the following statements. After you have read the statements, please sign and date
in the space provided below.
I understand that in the course of my work experience I may come into contact with confidential records
and
information. I agree to maintain the confidentiality of those materials and guard the private nature of
that
information, and to disclose such information only on a need to know basis.
I understand and certify the information contained in this application or other material provided to the City of
Copperas Cove, and in any oral statement made by me are true and correct. I have not omitted any information
and understand false or misleading information given in my application, resume or interviews will disqualify me
from further consideration. I understand information disclosed in this process may be disclosed in public meetings
and/or may be made available to the public.
I authorize investigation of all statements contained herein and authorize the references I have listed to
provide the City of Copperas Cove any and all information concerning information they may have on me,
personal or otherwise, and
release all parties from all liability for any damage that may result from furnishing
the same to the City of Copperas Cove.
I further authorize the City of Copperas Cove to conduct a criminal history background investigation as part of
this Advisory Body application process. I also agree to provide the City of Copperas Cove with any other
authorization or release necessary to
complete the required criminal history background investigation to
determine my suitability to serve in this capacity.
__________________________________ ____________
Signature Date
Please submit completed application to the City Secretary’s Office 914 South Main Street
Copperas Cove, Texas 76522 or email to Lisa Wilson at lwilson@copperascovetx.gov.
For further information call (254)547-4221.
DPS Computerized Criminal History (CCH) Verification
(AGENCY COPY)
I, , acknowledge that a Computerized Criminal
APPLICANT or EMPLOYEE NAME (Please print)
History (CCH) check will be performed by accessing the Texas Department of Public Safety Secure
Website and will be based on name and DOB identifiers I supply. (This is not a consent form.) Authority
for this agency to access an individual’s criminal history data may be found in Texas Government Code
411; Subchapter F.
Name-based information is not an exact search and only fingerprint record searches represent
true identification to criminal history, therefore the organization conducting the criminal history check is
not allowed to discuss with me any criminal history record information obtained using this method.
The
agency may request that I have a fingerprint search performed to clear any misidentification based
on the result of the name and DOB search. Once this process is completed the information on my
fingerprint criminal history record may be discussed with me.
In order to complete the process I must make an appointment with the Fingerprint Applicant
Services of Texas (FAST) as instructed online at www.txdps.state.tx.us /Crime Records/Review of
Personal Criminal History or by calling the DPS Program Vendor at 1-888-467-2080, submit a full and
complete set of fingerprints, request a copy be sent to the agency listed below, and pay a fee of $24.95
to the fingerprinting services company.
(This copy must remain on file by your agency. Required for future DPS Audits)
Signature of Applicant or Employee
Date
Agency Name (Please print)
Agency Representative Name (Please print)
Signature of Agency Representative
Date
Rev. 09/2013
Retain in your files
City Of Copperas Cove
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