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<br />{ ~~ 111995
<br />• City Of ,~~ APPLICATION FOR APPOINTMENT TO
<br />~~~ ~ CITY BOARD OR COMMISSION
<br />Rorer
<br />______________________________
<br />________________
<br />Please indicate by order which of the following you are
<br />interested in (1,2,3 etc.)
<br />,~_ Economic Development Authority
<br />Health Care Delivery Commission
<br />-~ Housing and Redevelopment Authority
<br />Library Board
<br />~, Park and Recreation Commission
<br />Planning Commission
<br />Utilities Commission
<br />------------------------------------------
<br />NAME :_ ~ (A _~, C~ A ~ ~ ~'P}P.t
<br />ADDRESS: ~9(~
<br />PHONE: (Homed (Work)
<br />OCCUPATION~~~N~r.. EMPLOYER ~ - _
<br />• ~
<br />.HOW MANY YEARS HAVE YOU LIVED IN ELK RIVER? _ ~ ?r~
<br />STATEMENT OF INTEREST:
<br />Please explain why you would like to serve on the board or
<br />commssian selected above?
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<br />EDUCATIONAL AND PROFESSIONAL EXPERIENCE:
<br />Describe your educational and professional experience or skills
<br />whi h qualify you to serve on this bo rd or commiss'on.
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<br />P.O. Box 490 • 13065 Orono Parkway • Elk River, MN 55330 • (612) 441-7420 • Fax: f6i21 441-7425
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