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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 />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 for the desired appointment: <br />• Name: (t,—Y—_.Bone: (H)?�Z'�--- <br />Address: _y�� City: State:—Zip:—.- <br />• <br />tate:Zip:• Name: i v� Phone: (FI)-- -._— (W) �� 1 <br />11 -- - <br />Address: State: <br />P zip: Sq� <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 d• a it is received. <br />YOUR SIGNATURE: _ Date: <br />Please return completed Rin 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 />