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A.1veT <br />APPLICATION FOR REAPPOINTMENT TO CITY ADVISORY <br />BOARD/COMMISSION <br />C ornnaission Reapplying for l...ubnaq :hoard, Cm"lRRL E,lk'Pjver <br />......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... <br />First Name Michelle Last Name Heagarty <br />Address 13559 1 2nad Lane NV7 <br />City Elk Rivet., State SIN Zile 55330 <br />Hoene Phon�11 Cell Phone Fnuail mighegarty@ gniail.com <br />Employer self Occupation fntenanty ediitor: <br />Public Contact Infort apt on <br />The cif maintains a directory of current board/corn mission rnnembers on the city's website. (once <br />appointed, state statute requires tnernnbers to provide au teleluhone, number, ennuau.il address, or both <br />Where tlne apnlulic°aunt canr lue neauclted. This is tlne corrtanct: arnfornnrartiotn Nu,e a�aill innclunde itn cuu;tr otnli.ne <br />ditectotlr. Please indicate which ch contact infoinnation voun'cu,°ouuld lire u:ns to use: <br />ICI Home Phone Number U Cell Phone T'"~ a nluer Lnucuil Address <br />;Mate briefly- why you are interested in continuing to serge on the lnoard/connnnission for which yon. <br />are seeking ueappointinent: Beinga pant on ccaunu:rn:uunnuntl voluunnteerisnaa IS inaugnortant to nose, ,4y life has <br />been heavily influenced by b-000Ls and it is tang goaul to n:nsaure, access to litenautlure, study nnaterianls, an <br />media ,,.)Tall kinds in iaurden t�aa suugague. rt the cnutncaal tlunnnlJrw inennnlaeu:s. Tltiat has tl'nuus fan: <br />lne,etn a wonderful exlnae,tlenncea. T likeand ltan'vew connections with other boara.l nrnennulnets Our rneetrrn-'s <br />have lnee.tu an bit elrstunl_uteel dufing the f7dutnelenntue arnu.l I atnn'n e crt:ecl to het back to m,�otUig fc)i Elk 'Rii ,et <br />alongside my fellow board members. <br />.Attendance <br />Are you aware of the iru portan ce of regaular uaueetin attendance inclMing the thane c onunauitranetnt <br />involved rn ireparinp-� fear meeatitn, s, andc o vonec yo n s inave t �ne t��uone ava� a e to dieanactive <br />lnat�ticipantYes J No <br />Conflict of Interest is defined as the participation in any, actiu-rt , recommended action, or decision <br />from 'n-lniclu the individual has or could have the potential to receive personal gain, whether it be direct <br />or indirect. Teo loud have au i7ledgal of equuitai le interest Noble lauusine�ss, however orgat �aaed, which <br />couugd bed coristmeed as a conflict ofrrnte.rea�st- U Yes <br />If lies, explain on a separate sheet of paper. <br />If your do not wish to seek teaingaoinntment, please check the below box. <br />IJ I dies not 7ish to seep teappointment:. <br />Applicant Signatme Dates MRG.I:.1 - thgilal 1 1'1712 ,2 <br />