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Special reasons for eishing to/serve/on the Board or Commission <br />Wtf:v �o Cd Voe..4- "i"aY fc,r;)s,%l O'F, <br />iY t'V YCa Jjc �ibn�_Goh Ci!!t' /'IW P� Q /t 1N..�.v_97s.�' <br />Dt rGSi� a Ccn Ot.t*- V.—� <br />What advisory panels, BoardslCom missions have you previously served on? <br />lVane, ih TAit C., fy. <br />Please list any training or experience you have that would be beneficial to serving on the Board or <br />Commission: 6ill 9 G✓rYC»'F T�hbnciF, lr f�NJn� olng AAve. <br />F�e�r�enarra QS ayo�t[_ Of FiLy- In '1`'JijJ- .(�}I-e_, <br />Are you available to attend board meetings during the day or evening M-F? <br />If no, please explain: Ye f <br />Please furnish two references who could speak to your qualifications for the desired appointment: <br />• Name: L¢dd, aA1c�— Phone: (H) 253-720-7 (74 <br />Address:20901 f}IZ 97 City: GJ'eCF1'm1 State: W/4 Zip: � 72,Z <br />• Name: �ya'YI R ai Phone: (H�Sa%-J�%— �' 3V) <br />_ <br />Address: g' Ira - Hgi e �� City C le EI�State; L✓/ ia Zip: q&'� Z z <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: yy �_ Date: 01 f7 $ �02 <br />Please return completed form to: Board of Kittitns County <br />Commissioners 205 W.51h, Room 1118 <br />Ellensburg, WA 98926 <br />509.962,75011 or hoccGPen.klidrnsnvu,us <br />PLEASE NOTE: ALL APPLICATIONS SURMITPIs`U TO T HE BOARD ONE COUNTY <br />COMMISSIONERS FOR AI'1'OIMI'R1h.N'I' 111+COM4; OFhICIAL PUBLIC RECORDS. <br />MCam Scanner <br />