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Special reasons for wishing to serve on the Board or Commission: <br />What advisory panels, Boards/Commissions have you previously served on? <br />Please list any training or experience you have that would be beneficial to serving on the Board or <br />Are you available to attend board meetings during the day or evening M -F? <br />If no, please explain: <br />Yes [ ] No <br />Please furnish two references who could speak to your qualifications for the desired appointment: 7,� <br />• Name: �?B�1oc/ Phone: (H) J3b9.'7-45. Lf3 L 4�7 VbQ 0 ��`' <br />Address: I002 _�- - ia.4ity: e&16 State: W— zip: p <br />d Name: _� YU GSL ✓ A.+D/J Phone: (H) M) ",I. rw 6/ve*0 <br />t �p� <br />Address: l.°G�� City T/'�_State: I*—Zip: <br />I <br />Your application will be placed with others interested in serving on the same board or commission. <br />When a vacancy occurs on the and/Commission in which you have indicated an interest, the <br />Board of County Comrnis5ione y de 're to conduct an interview. <br />YOUR SIGNATURE: Da 2V )4 r � <br />Please return completfa4to <br />Board of Kittitas County Commissioners <br />205 W. 5", Room 108 <br />Ellensburg, WA 98926 <br />509.962.7508 FAX: 509.962.7679 <br />PLEASE NOTE: ALL APPLICATIONS SUBMITTED TO THE BOARD OF COUNTY <br />COMMISSIONERS FOR APPOINTMENT BECOME OFFICIAL PUBLIC RECORDS. <br />