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C~VIC AND COMMUNITY <br /> <br />Describe past or present cMc and/or cornmumw activities that may be relevant in quali~,ing you to <br />se=,e on e2s boara or com~ssion. 7~i~ is n~y ~2;~s+ O,~¥,~e~r,+ 4-° a, t0~,l. I~ <br /> <br />ATTENDANCE: <br /> <br />Are you aware of- the zmportance of regular meeting attendance including the tinae cormxinrmnt <br />revolved m preparing for meetings, and do you feel you have the ttme available to be an active <br /> __~ Yes No <br />participant: <br /> <br />Co~rnnents: <br /> <br />CONFLICT OF INTEREST: <br /> <br />I ~xdsh to disclose the following potential conflicts of interest that may or will arise if I become a <br />member of tlzis board or co~rurfission. (See attached "Conflict of Interest" Ordinance) <br /> <br />Signature Date <br /> <br />The selection process will vau~ according to the number of appkicants and vacancies, and may not <br />include intendews with all candidates. <br /> <br />THANK YOU FOR YOUR INTEREST IN SERVING ON A BOARD OR COMMISSION. <br /> <br />Return Application To: <br /> <br />CitT of Elk River <br />Cit5- Clerk's Office <br />13065 Orono Par!ox, ay <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 />Fax: 763.635-1090 <br /> <br />S:clerk/bardcom/application/application <br /> <br /> <br />