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CIVIC AND COMMWNITY ACTIVITIES: <br /> <br />Describe past or present civic and/or community acfiv/des that may be relevant in qu,-4ifying you to <br />serve on riffs board or commission. <br /> <br />ATTENDANCE: <br /> <br />Are you aware of the importance of regular meedng attendance including the dme commitment <br />involved in pr,eparing f'or meetings, and do you feel you have the firne available to be an acdve <br />participant: 7< 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 ifI become a <br />member of this board or commission. <br /> <br /> ~" /i'fLL"'l,'~"~ L.~_)<7. L: ~ <br />Signature Date <br /> <br />The selection process will vary according to the number of applicants and vacandes, 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, MZN 55330 <br /> <br /> OFFICE USE <br />~ppointed To: ./l/~ 7'- ~',~'),~) /,~ /-~ t7 <br /> <br />Date Appointed: <br />Term Length: /~)0/2 /~ ~'//~// <br /> <br />Phone: 763.441.7420 <br />Fax: 763.441.7425 <br />www. ci. elk- aver.mn, us <br /> <br />s:XclerkXboardco m\application.doc <br /> <br /> <br />