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APPLICATION FOR REAPPOINTMENT TO CITY <br /> City*of ADVISORY BOARDICONMISSION <br /> Reappointment to: Ice Arena Commission <br /> %3065 0—%a Parkww <br /> AEP—LI-4;ANTjT9F9RMAIfs <br /> N <br /> Njmec . Kent Madsen City of Residence: __FA River <br /> Occupation: Bridge Safety ln§pcctor Employer. City of Mirmea lis <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 /> -Jkgau,sg a cao abut mu Ice arena and how its run, <br /> Relevant Experience: Please describe your educational,professioM4 civic, or community <br /> participation,-which may be relevant in serving on this board/com�ission, <br /> I have a college graduate with a minor in Recreation. I help run the arena for cane year, <br /> -- <br /> I was on the Elk River Youth Hockey Board for 13 years when we owned the Barn. I was on <br /> the City's Park Commission for many years, <br /> Attendance:Are your-aware of'the importance of regular meeting attendance including the time <br /> cornrnitrueat involved in preparing for meeting's,and do you feel you have.the time available to be <br /> an active participant? M yes Q No <br /> Comtnents: <br /> Conflict of Interest is defined as the participation in any activity,recommended action, or derision <br /> frorn which the individual has or could have the potential to receive personal gain, whether it he <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? 0 yes W No <br /> If yes,provide details on a separate ice oLf 2aVcr. <br /> 1/09/2019 <br /> Applicant Signature Date <br /> Applications will be kept on fllefor one year,after that time,a new application must be filed. <br /> OFFICE USE ONLY <br /> Council Meeting Datc. <br /> U Reappointed <br /> Term Expires- <br /> LJ Not Reappointed <br />