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Special reasons for wishing to serve on the Board or Commission: <br /> vfr► <br /> What advisory panels, ourds/Com fissions have you previously served on? <br /> Please list any training or experience you have that would be beneficial to serving on tl Board or <br /> Commission: v ` WPI, RC e c y <br /> S 4 S n5T <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 /> l <br /> ■ Name: i t��l �`'bV_0,a# 14 Phone: (H) <br /> Address: ] City: L UI=NSSIn.12,Cr State:0, 7ip:w' 2r <br /> • Name: j a-4-A -.Phone: (H) 42-4 .cil1 .5d&-p(v1� <br /> Address: City FSTYER ►LA1)Ay_State: CA Zip: <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's received. <br /> YOUR SIGNATURE: Y1 "�er!^-- Date: I 2 2 <br /> Please return completed form to: Board of Kittitas County Commissioners <br /> 205 W.51h,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 />