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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 />Please list any training or experience you have that would be beneficial to serving on the Board or <br />Are you available to attend board meetings during the day or evening M-F?If no,please explain:( <br />Please furnish two references who could speak to your qualifications for the desired appointment: <br />•Name:A Phone:(H)(W)_G§M iO(a -}I <br />Address:C City:E kWS A State:\Ala Zip:S%¶2,4 <br />•Name:L i RL Phone:(H)(W)O \Q R 942 <br />Address:R W)E 3 6 W 'City fufuí fkit State:WA Zip:SS S24 <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:Date:22 <br />Please return completed form to:Board of Kittitas County <br />Commissioners 205 W.5th,Room 108 <br />Ellensburg,WA 98926 <br />509.962.7508or bocc@co.kittitas.wa.us <br />PLEASE NOTE:ALL APPLICATIONS SUBMITTEDTO THE BOARD OF COUNTY <br />COMMISSIONERSFOR APPOINTMENTBECOME OFFICIALPUBLIC RECORDS.