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Special reasons for wishing to serve on the Board or Commission: <br />= V„ovc-- nq gek)eca'\ o,v`ko,-�i©n arc aak-�- since Ta\\ 1g1l �1 <br />c� s <br />ve '��eelY\ i 1cin 0A �a rS +r►e1Ca i E <br />-,+r r,,-,ccrir\d eiv%nc)L C a ft VMKSQA cA tOu f\A +QfoYr WNA4i <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: <br />Are you available to attend board meetings during the day or evening M -F? <br />If no, please explain: <br />e <br />Please furnish two references who could speak to your qualifications for the desired appointment: <br />Name: c�S S \Gh� Phone: (H) 0R- aS - bY1 (W) �— <br />�,e cge�ca es <br />Address: '1O Sh�S�uSu.:n e city: V_1NeV)S\U0State:VJA Zip:°�$�2� <br />• Name: �° t r1 Y1lJV-\Phone: (H) 509"ck2q-'A1$2. (W) <br />Address: �3�-10 QX"/ City _'-1\ZhS�y ccs State: VJ/"N Zip: gBgZ(�o <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. We will retain your <br />application for 2 years from the date it is received. <br />YOUR SIGNATURE: y« Date: q 2O r <br />Please return completed form to: Bon/d of Kittitas County <br />Commissioners 205 W.Sth, Room 108 <br />Ellensburg, WA 98926 <br />509.962.7508 or bocc@co.kittitas.wa.us <br />PLEASE NOTE: ALL APPLICATIONS SUBMITTED TO THE BOARD OF COUNTY <br />COMMISSIONERS FOR APPOINTMENT BECOME OFFICIAL PUBLIC RECORDS. <br />