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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 />n 60 � r d s or Co -� r►, i ss�'o ,� <br />Please list any trainin or experience you have that would be beneficial to serving on the Board or <br />Commission: ,reAV er, 4'e . r Z -o we v <br />w-v�Aors kuA'4,a,, eke <br />A <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: <br />• Name: Zr-/t ev O A Phone: (H) <br />(MI) sa 9- V 9-�1)q <br />Address: gwo A'K City: RehA u C�, State: _Zip: <br />• Name: C (%S5 �_ Phone: (H) (W) S 9,1 J - I 3 I <br />Address: �13 A, 11%14 Sfi City —11CAS k State: �r A Zip: a CW <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: —VZ7 . Date: — o 0 15 <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 />