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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 />Commission <br />-^ V <br />Are you available to attend board meetings during the day or evening M -F? <br />If no, please explain: <br />Please furnish two references who could speak to your qualifications <br />cfor the desired appointment: <br />• Name: f_L--��Ar_hone: (H) `67,'7a�_(W)_ _ ------ <br />Address: _69v City: State: Zip: <br />• Name: 16- L 4'_ a Phone: (I -i) (W) <br />Address: �p11_ cityLL11 <br />_ State: Zip: ozif° ✓Y <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 th a it is received. <br />YOUR SIGNATURE: Date: <br />i <br />Please return completed I'clyn o: Board of Kittitas County <br />Commissioners 205 W.5th, 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 />