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<br />CIVIC AND COMMUNITY ACTIVITIES: <br /> <br />Describe past or present civic and/or community activities that may be relevant in qualifying you to <br />serve on this board or commission. <br /> <br />ATTENDANCE: <br /> <br />Are you aware of the importance of regular meeting attendance including the time commitment <br />involved in p"aring for meetings, and do you feel you have the time available to be an active <br />participant: Yes _ No <br /> <br />Comments: <br /> <br />CONFLICT OF INTEREST: <br /> <br />I wish to disclose the following potential conflicts of interest that mayor will arise if I become a <br />member of this board or commission. (See attached "Conflict of Interest" Ordinance) <br />~ ~K- K:m: ;<.J1<'-<~::J:I;;:;e.... ~. / W/FG r-.s <br />--rJ/6 .::5i-h3z.13:..u&<JE' CO 4"'fi07u.J~ <br />~ /.-Or <.,--~.-(ZP.f6~ <br />N/Z6r ~~~ ;-Iri'i;. A ~H-~ I-U1'"V7-1 c..:;iF-:C: I ~ - < ..) J <br />r:;;;!f;::NGp,--"ee 1(../,,_ 6:. ;hJ1) 7/2./& ~ 0 "-lfl:>"6 G,...",,~~ <br /> <br />~ .,- -~.~ hi" 8/IGIO~ <br /> <br />Signature Date <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 />OFFICE USE <br /> <br />City of Elk River <br />City Clerk's Office <br />13065 Orono Parkway <br />Elk River, MN 55330 <br /> <br />Appointed To: <br /> <br />Date Appointed: <br /> <br />Term Length: <br /> <br />Phone: 763.635-1000 <br />Fa.x: 763.635-1090 <br />www.ci.elk-river.mn.us <br /> <br />S:c1erk/bardcom/ application/ application <br />