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Special reasons for wishing to serve on the Baard or Commission: <br />What advisory panels, <br />Boards/Commissions have you previously served ojjn}}?-- <br />lryU-Al$. j4 , Pla)A <br />Please list any trainingr experience you have that would be henelkial to serving tBoard <br />or <br />Commission: 1317 M r�MAU 11.1-- <br />X <br />��! �'� -C'r� L►� n z �u �� r- i19 ri aJL <br />Are you available to attend board meetings during the day or evening M F? 14 Yes [ ] No <br />If no, please explain: _ <br />Please furnish two references who could speak to your gaallikations for the desired appointment: <br />• Name: bte-e -a <br />fnJas60-Al ice: M (W)-!'d9-SYI <br />Address: t3 N , r r►,'n a4e. k City: �'1 f t,z:� i� ��:< slate <br />Name: , � ,' i � Phone: (M -167 - l � � W) <br />Address: <br />City <br />Your appii ation will be placed with others interested in serving on the son board or commission. <br />When a vacancy occurs an the Board/Comminion in which you have indicated an interest, the <br />Board of County Commisaioners may desire to conduct an interview. <br />.1 <br />YOUR SIGNATURE: - �14 Date: !ao�i�. -d l <br />Please return completed form to: Board of Kiltitas County Commissi0ners <br />205 W. e, 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 />