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Attendance: Axe your aware of the importance of regular meeting attendance including the time <br />commitment involved in preparing for meetings, and do you feel you have the time available to be <br />an active participant? ®Yes ^ No <br />Comments: <br />Conflict of Interest is defined as the participation in any activity, recommended action, ox decision <br />from which the individual has ox could have the potential to receive personal gain, whether it be <br />direct ox indirect. (See attached "Conflict of Interest" Ordinance) <br />In accordance with this definition, do you have any legal or equitable interest in any business, <br />however organized, which could be construed as a conflict of interest? ^Yes ~ No <br />If yes, pr~vide details on a se crate iece of a er. <br />Applicant Signature Date <br />Questions may be directed to the Administration Department at 763.635.1000. <br />OFFICE USE ONLY <br />The Applicant is: ^ New Applicant Applying for Reappointment <br />Council Action: ^ Not Appointed <br />Appointed to: <br />Date Appointed: <br />Term Expires: _ <br /> <br />