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Special reasons for wishing to serve on the Board or Commission: <br />�V ee ix-) 'h'e' 11111Af/1 /e <br />G <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:_ G��lCc_•� _f�.�J•yr' <br />Are you available to attend board meetings during the day or evening M -F? <br />If no, please explain: <br />[ es. [ 1 No <br />Please furnish two references who could speak to your qualifications for the desired appointment: <br />■ Name: /i/ll�irisJ Llt.�rL Phone: (H) ��lF•�1/ (Wj � �- --/7? <br />Address: El AJ City: State: be� zip: <br />■ Name: w t7Ci+ ,� ? .� Phone: (H) -1110 (W) <br />Address: Av City 4.�i State: 4/1 Zip: _OL,7{� <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/Co 'on in which you have indicated an interest, the <br />Board of County Commiss' offe—r in sure to co uct an interview. <br />YOUR SIGNATURE: Date: //z <br />Please return completed form to: Board of Kittitas County Commissioners <br />205 W. 5th, 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 />