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Special reasons for wishing to serve on the Board or Commission: <br />/ What advisory panels, Boards/ConAnissions have you previously served <br />Please list any training or experience you have that would be 65neficial to <br />Are you available to attend board meetings during the day or evening M-F? <br />If no, please explain: <br />�OGw.0 DD C.+-.rlr..w��rr� t�-s�vlr <br />i �1t_aia�F ✓Y.. i�..C, <br />on the <br />M <br />Please furnish two references who could speak to your qualifications for the desired appointment: <br />• Name:1 i� tea— Phone: (I l2yd )g-16--011(W) <br />Address: %y23 7�i" 1/%� City: Oe State: P114 %ip: g' gs'i"27 <br />Name: 7/ b N /may 112 // Phone: <br />Address: 1�b. &rX 60/ City /yZ(ix��State:/,.,0 lip: <br />(H) ?` d 3 3 - Z1s12W) <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 dale it is received. / <br />YOUR SIGNATURE: � ;" L Date: <br />Please return completed form to: 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 />