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Attendance: Are your aware of the importance of regular meeting attendance including the time <br />commitment involved in preparing for meetings, and do you feel you have the time available to be <br />an active participant? ;A Yes ❑ 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 an business, <br />however organized, which could be construed as a conflict of interest? C7 Yes f"No <br />If yes, provide details on a separate ece of paver. <br />Ib � <br />Applicant ature Date <br />Questions may be directed to the Administration Department at 763.635.1000. <br />This application III-ik�i17- 6fiw 1Z:QCS�i'r i'- LbT <br />OFFICE USE ONLY <br />The Applicant is: <br />Council meeting date: <br />"* New Applicant ❑ Applying for Reappointment <br />❑ Appointed to: <br />Term Expires: <br />❑ Not Appointed <br />