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Zip <br />Hc�me Phane Number <br />C�i'�II�rT+Tiia �R1i�T:2� <br />Emaii Address <br />Public C�ntact <br />Infarmatian <br />Emplayer <br />Dccupatian <br />Why are you inte�ested <br />in serving on a city <br />�OI'1'l fl'115SI �Cl � <br />55330 <br />- <br />- <br />Email Address <br />Vermilion Medical Group <br />Nurse Anesthetist <br />I am interested in serving on this cvmmission to help steward our <br />publie �atilit'ses and spaces for aur community. <br />What skills, training, 1 am a successfuG small business owner of over 20 years. f have <br />and experien�e woufd been the Chief GVurse anesthetist at Her�nepin GaunQy Medcal <br />yDu bring #c� the ���ter o�erseeing an operating budget ak aver 9 million dollars. <br />cvmmission for which As a 20 plus year Lieutenant Colonel, I ha�e commanded <br />you se�k appaint�nent? Suargical teams in cambat during the Global war on Terror. I ha�e <br />been acti�e in our community through the "Vate yes on an actqve <br />elk ri�er" non-profi� cam�aign, the VFW, and other numerous <br />past youth activitaes. #his eQmmissian sems �o me #o be a logical <br />step tD help serv� the community. <br />These experiences have given me the perspective and <br />ex�erience tv effectively work with everyone to achieVe gaals <br />that are set forth hy the cammission an�i the City o# �Ik f�iver. <br />Confli�t of Interest <br />If yes, explairr: <br />Haw did yvu hear <br />abc�ut this vacancy? <br />�lectronic Signature <br />Agreement <br />Electronic Sigr�ature <br />Na <br />Freld nat completed. <br />Word of Mou#h <br />Ag ree <br />Jacab Q Kotzian <br />Email not displaying carrectly? View it in yflur browser. <br />