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4.2. SR 02-09-2004
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4.2. SR 02-09-2004
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1/21/2008 8:33:25 AM
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2/23/2004 7:29:40 PM
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2/9/2004
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CIVIC AND COMMUNITY ACTIVITIES: <br /> <br />Describe past or present civic and/or community activities that may be relevant in qualifying you to <br />serve on this board or co~runission. ~<, lc .~_,~c[ ~ e C ,' * 0 '+-' c ;4 ~ o ,-'-~-"*q <br /> <br />ATTENDANCE: <br /> <br />Are you aware of the importance o£ regular meeting attendance including the time commitment <br />involved in preparing for meetings, and do you feel you have the rime available to be an active <br />participant: ,)'"'Yes No <br /> <br />Comments: <br /> <br />CONFLICT OF INTEREST: <br /> <br />I wish to disclose the following potential conflicts of interest that may or will arise if I become a <br />member of this board or commission. (See attached "Conflict of Interest" Ordinance) <br /> /¢o o <br /> <br />Signature f] Date <br /> <br />The selection process will vary according to the number of applicants and vacancies, and may not <br />include interviews 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 River <br />City Clerk's Office <br />13065 Orono Parkway <br />Elk River, MN 55330 <br /> <br />Appointed To: <br /> <br />Date Appointed: <br /> <br />Term Length: <br /> <br />OFFICE USE <br /> <br />Phone: 763.635-1000 <br />Fmx: 763.635-109{) <br />xvw~v.ci.elk-river.mn, us <br /> <br />S:clerk/bardcom/application/application <br /> <br /> <br />
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