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<br />" <br /> <br />CIVIC AND COM1fOJ\TJTY ACTMTIES: <br /> <br />. <br /> <br />Describe past or present civic andJor community activities which may be <br />relevant in qualifying you to serve on this board or commission. <br />.r AAct/A- ~g~ ~IJ~ 1J ~ ~p~ S~. ~1 . <br />~~~~ SC1./Jd O"?\ ~ hfq,{ 5~~~-Nlql.f <br />p~' ~. I h/tvfl. ~efl.V6/j ~ ~ scflcc.e~~. <br />- d SeAR6\.. <br /> <br />ATTENDANCE: <br /> <br />Axe you aware of the importance of regular meeting attendance including the <br />time commitment involved in preparing for meetings, and do you feel you <br />have the time available to be an active participant: .A- Yes _ No <br /> <br />Comments: <br /> <br />CONFLICT OF INTEREST: <br /> <br />. <br /> <br />. <br /> <br />I wish to disclose the following potential conflicts of interest that mayor will <br />arise if! become a member of this board or commission. <br /> <br />"I \~VE:.I"-> (9~ <br /> <br />~-~ <br /> <br />Signature <br /> <br />--------------------------------------------------------------------------------------------------------- <br /> <br />Tbe selection process \\ill vary a.ccording to the number of applicants and <br />vacancies, and may not include interviews with all candidates. <br /> <br />THANK YOU FOR YOUR INTEREST IN SERVING ON A BOARD OR <br />COMMISSION. <br /> <br />R~4."rn Ann '11' f'ahnn To. <br />\..-LU ... ...~......... '-' ......v . <br /> <br />OFFICE USE <br /> <br />City Clerk's Office <br />City of Elk River <br />13065 Orono Parkway <br />PIa Box 490 <br />EUr River, MN 55330 <br />P!1one: 441-7420 <br /> <br />Appointment: <br /> <br />Date: <br /> <br />. <br /> <br />Term: <br /> <br />s: "orms\brdcomap.doc <br />