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Special reasons for wishing to serve on the Board or Commission: <br />� ���� � � u •►,ted, t,. � �� Com; H r� � c�' �wt �h' � �n�A•-'��x,. � �,�..� <br />(.Lj: r+'■ n A!Q t'► kir it + '�■ c� �.'yL Fc. r <br />,w L&yl� �G M {� \r 7. 1� {1�..�L j 1J�� �ir�� 7 • ■ �'6,r ; > �1 <br />�,p.e � `1:1..1k� . +.0 c� r t.� .'Ul •■ �'1 �.c.. �y r•c�..rGL �.� �. �c� 1r� �,� C� :.�f. �ar� �M�c•-h c:r k <br />��L...z Y.vr■� {+�c:,t=t-� t'+.c. �,+c.�L.11r rn b� _ c� �� tT caf- <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 />Commission:_. TAc �3•.-; i f _r' �Jv iA - rV;� Sell ',Sc� z�iLV1 <br />Coo i['A - <br />Are you available to attend board meetings during the day or evening M -F? <br />If no, please explain: _ <br />IQ Yes [ ] No <br />Please furnish two references who could speak to your qualifications for the desired appointment: <br />• Name: ,t, - �•' '% Phone: (H) <br />Address: <br />(W) �� 3c I.. ILX*-1 <br />City: lle 4 � State: � lily: -Z� <br />• Name: C -I fi .r iIY1 Phone: (H) -1b l ~ f?'8 ks (W) (.jpp) 201_ Lf'&p 4 <br />Address: 2351 5rraAJ' 4 e-( City alh-g5ho9 State: 1&-:1 zip: li3 q A <br />Your application will be placed with others interested in serving on the same board or commission. <br />When a vacancy occurs on the Board/Commission in which you have indicated an interest, the <br />Board of County Commissioners may desire to conduct an interview. <br />YOUR SIGNATURE: Date: 142- 3 <br />Please return completed form to: Board of Kittitas County Commissioners <br />205 W. 5`h, 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 />