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<br />CIV1C AND COMMUNITY ACTIV1TIES: <br /> <br />Describe past or present civic andf or community activities tbat may be relevant in qualifying you to <br />serve on this board or commissiorl. ~ () n-t; <br /> <br />ATTENDANCE: <br /> <br />Are you aware of tbe importance of regular meeting attendance including tbe time commitment <br />involved in preoiring for meetings, and do you feel you have tbe time available to be an active <br />participant: 1 Yes _No . <br /> <br />CO~\:~ \S sDrremitlCt \ hLl\fe, V\1O-n +t:d <br />~ 9M t- of for (lWVlt 1<:. <br /> <br />+0 <br /> <br />tecorre. <br /> <br />CONFLICT OF INTEREST: <br /> <br />I wish to disclose tbe following potential conflicts of interest tbat mayor will arise if I become a <br />member of this board or commission. (See attached "Conflict ofInterest" Ordinance) <br /> <br />- <br /> <br />~/5-ot/ <br /> <br />Date <br /> <br />E/l?~-L <br /> <br />19nature <br /> <br />--------------------------------------------------------------------------------------------------------- <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 /> <br />Appointed To: <br /> <br />Date Appointed: <br /> <br />Tenn Length: <br /> <br />Phone: 763.635-1000 <br />Fax: 763.635-1090 <br />www.ci.eIk-civer.mn.us <br /> <br />S:c1erkfbardcom/ application/application <br />