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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 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 and willing Elk River Resident <br /> <br />ATTENDANCE: <br /> <br />Are you aware of the importmce of regular meeting attendance including the time commitment <br />involved in preparing for meetings, and do you feel you have the time ava_ilable 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 will arise if I become a <br />member of this board or commission. <br /> <br /> None <br /> <br />Signature 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 /> OFFICE USE <br />Appointed To: /%} 0 aJ ~' - <br />Date Appointed: J"xO id ~.,, dF: \ <br />Term Length: <br /> <br /> Phone: 763.441.7420 <br />commission application. 1-29-03.doc <br /> Fax: 763.441.7425 <br /> <br />c:\unzippedXapplicationXco mplete er <br /> <br /> <br />