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Special reasons for wishing to serve on the Board or Commission: <br />I enjoy giving back to the community and under the right set of circumstances I am sure this <br />can be acco7iTt31Ishad <br />What advisory panels, Boards/Commissions have you previously served on? <br />budget committee for Newport Oregon 6 years, taskforce for the development of financing for a <br />MW-Clty water system.1 retTm-NewpO7i Oregon Parks <br />"and-�atiun Depaitinant <br />Please list any training or expeiience you have that would be beneficiplto serving on the Board or <br />Conim'ssion.40 years of asset management experience and supervision of others with simular <br />task in nk trusudepamn-e„ s Are you available to attentt board meetings during the day or evening M -F? <br />It' nu, please explain: either <br />Please furnish two references who could speak to your qualifications for the desired appointment: <br />• Name: John Sham Phone: (l -r) 509-850-8484 M retired <br />Address: 8505 E Broad Ct city:spokane state: wa zip: 99212 <br />• Name: robert w smith phd Phone: (H) 503-990-7285 M retired <br />Address: 1721 Lambert St Nw city Salem State: Oregon zip: 97304 <br />Your application will be placed with others interested in serving on (lie 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; Z Do? f <br />Please return completed form to: Board of Kittitas County <br />Commissioners 205 W,5th, Room 108 <br />Ellensburg, WA 98926 <br />509962.7508 or hocc@co.kittitas.wa.us <br />PLEASE NOTE: ALL APPLICATIONS SUBMITTED TO THE BOARD OF COUNTY <br />COMMISSIONERS FOR APPOINTMENT BECOME OFFICIAL PUBLIC RECORDS. <br />