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011'10/2011 12:36 76342r0533 E H RENNER & SONS IN PAGE 03%02 <br />~Attendanee: Axe your aware of the importance of regular meeting attendance including the time <br />commitment involvcd,~ preparing for meetings, and do you feel you have the time available to be <br />an active participant? Yes ^ No <br />in, accordance~~vith this dcfuiition, do you Dave any legal or equitable interest in any business, <br />however organized, which could be construed as a conflict of interest? ©Xes ^ No <br />If yes, provide derai)s on a se~oicce of a ez. <br />.A.pplicant attire Date , <br />Questioo.s nrzay be directed to the Administration Department at 763.635.1000. <br />OFFICE USE ONLY <br />The Applicant is <br />New Applicant <br />^ Applying for Reappoin.txx~ent <br />Council Action: <br />^ Not Appointed <br />O .fippointed to: <br />Date Appointed: <br />Term Expites~ <br />Conflict of In.taee~t .iF delxxned as the participation in any actitrity, recommended action, or decisaoza <br />from which the individual has or could hate the potential to receive pcxson.al gain, whether it be <br />duect or indirect. (see att~ehed "Conflict of Intezest" Ordirnan.ce) <br />