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APPLICATION FOR REAPPOINTMENT TO CITY <br />ADVISORY BOARD/COMMISSION <br />Reappointment to• <br />APPLICANT INFORMATION <br />,,,` <br />Name: ~ 0.,` ~ ~ - l~Q (~ ` '^ City of Residence: ~ ~ ~~ ~ ~'L' <br />Occupation: ~ lx Ss1~1 E. S S ' ~N~ L Y S 1~ - Employer: ~ ~~ ` ~~~ ~' £!y~ 2"C~ <br />Statement of Interest: Please state briefly why you are interested in continuing to serve on the <br />board/commission for which you axe seeking reappointment. <br />~l.r~,R; i Sti t', ~ d!"~--A Z'NiS.I-~iT ~/~ !-~~~o~.~-A~y6 ~ ~MfdtlJf/.•-r-G- <br />t'i~€~`'~Z.~ A-n-SiN !~ r41c ~. `:~Y`l , Tlf ~. P~9-`~~ s' A~~S o r..s~ -~-~1 ~ w ~--~i <br />~ G ^~ (L...~.•~r-~- ~~ sYN,4 ~ A s J.~ ~ .yam G T~iJ .T M ! /~-v/~r C+ f 0 ~- e-f f! F tc. s ~ <br />f~n.4 ~'-~ ~r~-~dr- r~~-.= ~ s w.~ ~ u s~r2 G~ ~E' S <br />Relevant Experience: Please descn-be your educational, professional, civic, or community <br />participation, which may be relevant in serving on this board/commission. <br />~Y <br />1~- ~.FA-s k. Q- FJL. ~ ~ 2 'Z ~C ~~-s <br />3Lt~~ LyN ~. ~ 2~ <br />~O ~ F.- <br /> <br />15'~ 1 - 1 <br />~`~~'Mo~-d00 <br />~p ~.~-~s-~ ~. <br />9 8' <br />N <br />.~ ~ ~? Es cn-, <br />~~~ G c7 .~. w~. ~ S -+-~ N <br />Attendance: Are 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 />_~ <br />Conflict of Interest is defined as the participation in any activity, recommended action, or decision <br />from which the individual has or could have the potential to receive personal gain; whether it be <br />direct or 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, provi/d/~e details on a se axate iece of a er. / <br />Applicant Signature . Date <br />Applications will be kept on 81e f+vr one year; after that time, a new application must be filed. <br />OFFICE USE ONLY <br />Council Meeting Date: <br />^ Reappointed <br />Term Expires: _ <br />^ Not Reappointed <br />_~ <br />