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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: StC\Ce 141o0iCNSko E < s)42. T coo r yeasts evr3o L i <br /> hone. �StCt\ it Ncrt 4ceri en pos44G1 pcdl ng jC1 ��+✓ cnMD&uON <br /> OUJ ciaak.t have, '6 cue voi-� ii-:�$� <br /> y eke-� <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 kNo <br /> If yes,pro,'de details on a separate piece of paper. <br /> VO <br /> Applicant Signa e Date <br /> Questions may be directed to the Administration Department at 763.635.1000. <br /> This application will be kept on file for one year; after that time a new application <br /> must be — <br /> ---___-- --------__—_ —_ <br /> OFFICE USE ONLY <br /> The Applicant is: ANew Applicant ❑ Applying for Reappointment <br /> Council Action: ❑ Not Appointed <br /> ❑ Appointed to: <br /> Date Appointed: <br /> Term Expires: <br />