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V <br />Are you available to attend board meetings during the day or evening M -V' <br />If no, please explain: <br />Special reasons for wishing to serve on the Board or Commission: <br />b. ( 1 11 0, LI-) <br />.— E tt <br />What advisory panels, Boards/Commissions have you previously served on? <br />GN� � <br />0 � a , ve <br />Please list any training or experience you have that would be beneficial to serving on the Board or <br />Omission: <br />�1�CJ64T 5 1 �(J t,y i/� {•svFSt`tn� L1r� I i.r�•� (1u �Gi�n cella, <br />l vires l 1 Ivo <br />Please furnish two references who could speak to your qualifications for the desired appointment: <br />• Name: <br />Address: <br />Phone: (H) <br />City: <br />State: <br />(W) <br />Zip: <br />y51lb <br />e Name: Phone: (H) '3`1i qZ - ,(W) <br />' 7$�Z� <br />Address: `� b I `G . Y W rr i P,l�/ �� __City _ ��GytS�J c l ��j _State: �it)� Zip: <br />Your application be placed with others interested in serving on the same board or commission. <br />When a vacan occu , on the Board/Commissj'An in which you have indicated an interest, the <br />Board of Coun Comm sioneies qfa`y�%ire to nd'ct an interview. <br />© L 7 t_ <br />YOUR SiGNATUR- �J Date: � �z r, <br />Please return completed form to: Board of ICittitas C unty Commissioners <br />205 W. 5`", Room 1 8 <br />Ellensburg, WA 9 926 <br />509.962.7508 AX.: 509.962.7679 <br />PLEASE NOTE: ALL APPLICATIONS SUBMITTED TO THE BOARD OF COUNTY <br />COMMISSIONERS FOR APPOINTMENT BECOME OFFICIAL PUBLIC RECORDS. <br />