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CPv~IC AND COMMLINITY ACTIVITIES: <br /> <br />Describe past or present civic and/or communiq, activities that may be relevant i~ qualifying you to <br />serve on this board or commission. <br /> <br />Past Cub Scout Den Leader and Cub Master <br />Past Council Member Maple Grove Lutheran Church <br />Active ERHS Student parent <br />Concerned md willing Elk Kiver Resident <br /> <br />ATWENDANCE: <br /> <br />Are you aw~e of the importance of regul~ meeting attend,-mce including the time commitment <br />involved in preparing for meetings, and do you feel you have the time available to be an active <br />participant: X Yes __ No <br /> <br />Comments: <br /> <br />See attached Statement of Qualification/Interest <br /> <br />CONFLICT OF INTEREST: <br /> <br />I wish to disclose the following potential conflicts of interest that may or w/Il arise if I become a <br />member of this board or commission. <br /> <br /> None <br /> <br />Signature Date <br /> <br />The select/on process will var3., according to the number of appl/cants and vacancies, ,'md ma}, not <br />include interviews with all candidates. <br /> <br />THANK YOU FOR YOUR INTEREST IN SERVING ON A BOARD OR COI"INISSION. <br /> <br />Return Apphcation To: <br /> <br />CiU' of Elk Kiver <br />Ciu' Clerk's Office <br />13065 Orono Parkway <br />Elk River, MN 55330 <br /> <br />Appointed To: <br /> <br />'Date Appointed: <br /> <br />Term Lengfl~: <br /> <br />OFFICE USE <br /> <br /> Phone: 763.441.7420 <br />commission application. 1-29-03. doc <br /> ~ax: 7o3 44! 7425 <br /> <br /> ] <br />c:",unzippec&,application ,complete er <br /> <br /> <br />