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6.1. SR 10-212002
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10/21/2002
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6.1. SR 10-212002
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1/21/2008 8:31:57 AM
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10/18/2002 7:46:44 PM
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City Government
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SR
date
10/21/2002
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0IVI0 AND COMMUN~TT ACTR/~T{~S: <br /> <br />Describe past or present civic and/or COnllT1LIFIi~iV ~C~%ri~e$ ~12t Ill~y be relevant m qu~%,mg you to <br />se~e on ~ns board or conn~ssion. <br /> <br />ATTENDANCE: <br /> <br />Are .you aware o£ d:e U-nportance of regular meeting ,~:tendance including the twne conm~im:en: <br />involved m p:eparm6 £o~ meem:gs, and do you £eei you have the ~e avail:ble to be an active <br />pa:ricipant: ~,Yes __ No <br /> <br />Con%merits: <br /> <br />CONFLI ~T OF INTEREST: <br /> <br />I ~vish to disclose d:e £ollowmg potential conflicts of interest d:at may or will arise if I become <br />member o£ d-ds board or conm2ission. <br /> <br /> ,-,u. . - <br /> <br />The selection Erocess wRt v~ accordm~ :o dC n:mber o£ aEBEc:nts :nd vacancies, and may aot <br />red.de iate:dews ~vith all c:ndid~ms. <br /> <br />THANK YOU FOR YOUR INTEREST IN SERVING ON A BOARD OR COMMISSION. <br /> <br />Return AppLication To: <br /> <br />Cit7 o£ Ell< River <br />Cit7 Clerk's Or'ce <br />13065 Ozono Parkxvay <br />Elk River, MN 55330 <br /> <br />Appointed To: <br /> <br />Date Appointed: <br /> <br />Term Length: <br /> <br />OFFICE USE <br /> <br />Phone: 763.441.7420 <br />Fax: 763.44'1.7425 <br /> <br />s:Xclerk',boardcom\appiication.cloc <br /> <br /> <br />
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