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8.4. SR 12-15-2014
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8.4. SR 12-15-2014
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12/12/2014 8:50:09 AM
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SR
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12/15/2014
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L�� A PPLICATION FOR REAPPOINTMENT TO CITY <br /> city os ADVISORY BOARDICOMMISSION <br /> Elk <br /> RiVer Reappointment to: K R A <br /> 13065 Cl-Parkway <br /> 763.635.1000 <br /> APPLICANT INFORMATION (� <br /> Name: �- out,5e Ku � City of Residence: �.-� KIUL) E <br /> Occupation: V ET tREb_ 0,. L _ ._ Employer: _-- R sx{a eD <br /> Z0L)PS6L <br /> Statement of Interest: Please state briefly why you are interested in continuing to serve on the <br /> board/commission for which you are seeking reappointment. <br /> rVE- S.rAvoc�, tw . 5T iQ POL-LCr "ID S uC <br /> 0 v'I- v V P o(k-N.0 L 'R E S -M 63 A-C T- V is LY L1 J V O L U i~D . P A&AI Gu L.V<,W <br /> L 1J LO C/{- G o SRN M i-N'l' W tzh c i-- t'5 M XXz>A- t M 8,4C-T C->N -€. <br /> x �- �.-�. <br /> elevant perience: V11 ease describe your e ucationa , professional, civic, or community CNnU <br /> participation,which may be relevant in serving on this board/commission. rX,► Eu v�1 <br /> (h E-X r S 014 & UAAA Of 8 0 2�S,C c�'�n,P►n l 5 t a S �'� <br /> P2 casrc e f. <br /> P.LIJ �J1P(, Co-nm►SSto)V) <--c`ry r©UUC. tL, ) GRAL 604RD , <br /> true PROVIDED UPPUrt -V��77�i� ©C� Pvc U?� L "A�1V�� .J <br /> Of -ril-S COM^.).K;I rY P aQ Cj-SS �r�.?��i r4 lr �fi+l�J���� "D <br /> Attendati ce:Are your aware of the importance of regular meeting attendance Iudmg the time <br /> commitment involved in preparing for meetings, and do you feel you have the time available to be <br /> an active participant? XYes ❑ No <br /> Comments: <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 ANo <br /> If , provide details on a separate pitce of paper. <br /> Applicant Signature Date <br /> Applications will be kept on file for one year,after that time, a new application must be filed. <br /> OFFICE USE ONLY <br /> Council Meeting Date: <br /> ❑ Reappointed <br /> 'Fenn Expires: <br /> ❑ Not Reappointed <br />
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