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5.9. SR 11-12-2002
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5.9. SR 11-12-2002
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1/21/2008 8:31:58 AM
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11/12/2002 9:36:41 PM
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City Government
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SR
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11/12/2002
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CIVIC AND COMMUNIIt' ACTR/ITr~S: <br /> <br />Describe pas~ or present civic and/or con~umw acm~mes ~h~ m~y be relev~n~ m qu~%,mg ?ou to <br />sez~e on ~s board o~ con~mssion. <br /> <br />ATTENDANCE: <br /> <br />A~e .you a~vare o£ fl~e U~portance of regular meem~g attendance including t22e t2ne conm2.ir_ment <br />revolved m preparing for meem~gs, and do you fed .you have d~e tm2e availaNe to be an actSve <br />participant: '~NYes __ No <br /> <br />Conm~ents: <br /> <br />CONFLICT OF INTEREST: <br /> <br />I w~sh to disclose d2e £oilowm6 potential conflicts of interest d2at may or will arise [£ I become <br />member of dxis board or cormxdssion. <br /> <br /> ............. __{_ .... .................................................. ............... <br />The selec=on process w~ vaz7 accor~g to the number of applcants and vacancies, and may not <br />include mte~wie~vs ~vid~ a~ can~dams. <br /> <br />THANK YOU FOR YOUR INTEREST IN SERVING ON A BOARD OR CONNISSION. <br /> <br />Ret-urn Application To: <br /> <br />Cit7 of Elk River <br />Cit! Clerk's Office <br />13065 Orono Parkway <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: 763.44'12425 <br />~,~v~¥. Cl. e~k- rlV ~r. i1'111, kls <br /> <br />s:'xclerk'xboardcomXappiication.doc <br /> <br /> <br />
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