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SEP. 2.2003 3'53PM ELK_RIVER_CITY_HALL N0.466 P. 5/6 <br /> <br />CMC AND COMMUNITY,6CTIVITIES: <br /> <br />Dcsc~be past or ?resent civic and/or community activities that may be zelevant ~u qualifying you to <br /> <br />Ate you aw~e of the importance of regular meeting attendance iucluding the time commitment <br />h2volved m preparing for meeth2gs, and do you feel you have the time avaihble to be ~m active <br />p~ddpant: ~ Yes ~ No <br /> <br />C.ONFLICT OF II~CFE~ST: <br /> <br />I ~rish to disclose fl~e follo-,.vmg potential conflicts o£int=est that rmy o; ~ ~_tise if ! become a <br />Inember of this board or commission. (See attached "Conflict o£ Interest" Ordin~x~ce) <br /> <br />Signature ~ - -- Da~e / <br /> <br />The selection process will rs_fy according to the number of applicants and vacancies, a~d may not <br />include inte~0~ews with all candidates. <br /> <br />THANK YOU FOR YOUR INTEREST IN SERVING ON A BOARD OR COMMISSION, <br /> <br />Return Application To: <br /> <br />City of Elk Riv~ <br />City Clerk's Office <br />13065 O~ono Parkway <br />Elk Rive~, MN 55330 <br /> <br />Appohxtefl To: <br /> <br />Date Appointed: <br /> <br />Te~n Le~: <br /> <br />OFFICE USE <br /> <br />Phone: 763,6;~$-1000 <br />F~: 763.63~-1090 <br /> <br />S: clcrk/b ~,rd¢om/~ppllc~.6,on/* ppEcafion <br /> <br /> <br />