HomeMy WebLinkAboutCurtiss ApplicationAPPLICATION FOR APPOINTMENT
TO KITTI'T'AS COUNTY BOARDS & COMMISSIONS JUL 70
Citizen boards and commissions are critical to the effective functioning of County government: We
appreciate your interest in wishing to serve Kittitas County and ask that you complete this brief
application. If you wish, please feel free to attach a fact sheet or resume to this application. This
application form is considered a public document. PLEASE PRINT CLEARLY.
BOARDS OR COMMISSIONS FOR WHICH YOU WOULD LIKE TO BE CONSIDERED:
Date: 7.26. !1-�:
Name: •t/[ r1 S
Business Address: Home Address: r �D II D
City State Zip
Business Phone:
jp;'�"kexp
Home Phone:
/� � Msar �
96w* AA- fttk
City I� State Zip
3M. q4 k-- 960
Email �d�iri ss: GlA��/LCU�TrSS �(5 At A/C . CorN
Education: (High sch 311, name and location of college or university, year graduated, and degree):
G
Cu rent Em lovinent: (job title, employer, employment date, contact, phone):
`
PLEASE NOTE: ALL APPLICATIONS SUBMITTED TO THE BOARD OF COUNTY
COMMISSIONERS FOR APPOINTMENT BECOME OFFICIAL PUBLIC RECORDS.
Special reasons for wishing to serve on the Board or Commission:
What advisory panels, Boards/Commissions have you previously served on?
Please list any training or experience you have that would be beneficial to serving on the Board or
Are you available to attend board meetings during the day or evening M -F?
If no, please explain:
Yes [ ] No
Please furnish two references who could speak to your qualifications for the desired appointment: 7,�
• Name: �?B�1oc/ Phone: (H) J3b9.'7-45. Lf3 L 4�7 VbQ 0 ��`'
Address: I002 _�- - ia.4ity: e&16 State: W— zip: p
d Name: _� YU GSL ✓ A.+D/J Phone: (H) M) ",I. rw 6/ve*0
t �p�
Address: l.°G�� City T/'�_State: I*—Zip:
I
Your application will be placed with others interested in serving on the same board or commission.
When a vacancy occurs on the and/Commission in which you have indicated an interest, the
Board of County Comrnis5ione y de 're to conduct an interview.
YOUR SIGNATURE: Da 2V )4 r �
Please return completfa4to
Board of Kittitas County Commissioners
205 W. 5", Room 108
Ellensburg, WA 98926
509.962.7508 FAX: 509.962.7679
PLEASE NOTE: ALL APPLICATIONS SUBMITTED TO THE BOARD OF COUNTY
COMMISSIONERS FOR APPOINTMENT BECOME OFFICIAL PUBLIC RECORDS.