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<br />JUL 28 1
<br />
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<br />Ci'YO~
<br />IEIJ{r_River
<br />
<br />---------------------------------------------
<br />
<br />APPLICATION FOR APPOINTMENT TO
<br />CITY BOARD OR COMMISSION
<br />
<br />Please indicate by order which of the following you are
<br />interested in (1,2,3 etc.)
<br />
<br />---------------
<br />
<br />.;(
<br />
<br />Economic Development Authority
<br />Health Care Delivery Commission
<br />Housing and Redevelopment Authcrity
<br />Library Board
<br />Park and Recreation Commission
<br />Planning Commission
<br />Utilities Commission
<br />
<br />=r..
<br />
<br />---------~---------------------------------------------~-----~.
<br />
<br />.
<br />
<br />NAME: ",,) ltd"r lho~ ? S0"'-.
<br />ADDRESS: f1.{.l~::l... l-S'.;t."d. i-\1re'.(;.LG'.
<br />PHONE: (HOme>! - (WOrk)J
<br />OCCUPATION "R€ ve.'II.\oU?. S"U,fEV'vi-;:'DV"' EMPLOYER H-e l'IV1e_p;" Ya.rI<S
<br />HOW MANY YEARS HAVE YOU LIVED IN ELK RIVER? ?S C1 rS .
<br />.J
<br />
<br />STATEMENT OF INTEREST:
<br />
<br />.
<br />
<br />Please explain why you would like to serve on the board or
<br />commission selected above?
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<br />EDUCATIONAL AND PROFESSIONAL EXPERIENCE: j:;,~ai!:' .1'lJ' . 'fit-:U.-
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<br />Describe your educational and profeSSional exper~ence or skills ~'
<br />which qualify you to serve on this board ok commission.
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<br />
<br />P.O. Box 490 . 13065 Orono Parkway. Elk River, MN 55330 . (612) 441-7420 . Fax: (612) 441-7425
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