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<br />CIVIc ANn CO'MMlTNT'TV ACTIVl'I'.tES: <br /> <br />Describe past or present civic and/or community activities that may' be tel~t in qualify.ing you to ) <br />serveonthisboardorCOmmission. ,41)/ fotJ/ .6y /ArfJCII~1In"" ~n -f],II.1 h04... <br />/j ftJ 5.j,4r-f (j..f..,.f6Y17 NJiU"-C Inv,lvc.d J.. ll'.1 · I <br />1/ WJ J -r -'t f.J--.. t:4".., ...., ""10"'\ J ~ <br /> <br />ATTENDANCE: <br /> <br />Are you aware of the importance of ~ar meeting attendan.c:e including the time commitment <br />involved in p~eearing for meetings, and do you fed you have the time available to be an active <br />participant: X Yes _No <br /> <br />Comments: <br /> <br />CONFLICT OF IN'I'F.RF.s.I;. <br /> <br />I wish to disclose the following potmtial conflicts of inte:tcst that tnay or will arise in becotne: a <br />member of this board or commission. (See attached "Conflict of Intetc$t" Ordinance) <br /> <br /> <br />z. h;/"/' <br /> <br />, , <br />Date <br /> <br />The selection process will 'V2ty according to the number of applicants and vacancies, and may not <br />include interviews with aU candidates. <br /> <br />-----------..-------..------------..---.------... <br /> <br />THANK YOU FOR YOUR INTEREST IN SERVING ON A BOARD OR COMMISSION. <br /> <br />Return Application To: <br /> <br />City of Elk River <br />City Clerk's Office <br />13065 Orono Parlcway <br />Elk River~ MN 55330 <br /> <br />OFFICE USE <br /> <br />Appointed To: <br />Date AptlOil1ted:; <br />Term Length: <br /> <br />s: \ C1..E1U:. \ 1t0 ARDt:()M \ Af>pI;l;;1li.." ",.d J)~""CtiPlh,", \ "I)I)U".lti"nltEYJ ~EO.I )OC <br /> <br />PhotIe: 76.l.&3s.tOOO <br />FIX: 763.635-1090 <br />""""" .ci.eIlc-rivcr.lDl1.... <br /> <br />9n-~ tOO/ZOO' d SII-! <br /> <br />tSZ6-ltZ-SSl+ <br /> <br />NOISIA ~3)lNVll "3Ma'ro_~ WVZl=11 SOOZ-OI-1l3~ <br />