HomeMy WebLinkAboutHerumAPPLICATION FOR APPOINTMENT
TO KITTITAS COUNTY BOARDS & COMMISSIONS
Citizen boards and commissions are critical to the effective functioning of County govcrijm K,�Ze-z
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appreciate your interest in wishing to serve Kittitas County and ask that you catttplete tltis 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:
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Date: _.Q Vlti b e r 2 t °2 17
Name: , O c k t e He V- U W\,
Business Address:
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Home Address: I C) 5. Va I Pt U t St
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Business Phone: Home Phone:
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Egeation: (Hi h S hnol, name and location of college or university, year graduated, and degree):
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Current Employment: (job title, employer, employment date, contact, phone):
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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:
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What advisory panels, Boards/Commissions have you previously served on?
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Please list any traininor experience you have that would be beneficial. to serving on the Board or
Commission: ele- Lr Ss4iio Dk Z sec ref ar 6f' IzWX. e -
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Are you available to attend board meetings during the day or evening M -F? [ tfVes [ ] No
If no, please explain:
Please furnish two references who could speak to your qualifications for the desired appointment:
• Name: LaSso't& , Ati Phone: (H) Sol ME 30.'u (W)
Address: JLL68 [y• kttq holia_ City: StdVk0Lyle State: VJA Zip: �9 � � 7
• Name: TiM B to 55 Phone: (H) 36D 7143794 (W)
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Address: N1�; vLf'V I L �U b rl Ue City q, _1"li D b� �De _State: � Zip: 58 �T
Your application will be placed with others interested in serving on the same board or commission.
When a vacancy occurs on the Board/Commission in which you have indicated an interest, the
Board of County Commissioners may desire to conduct an interview.
YOUR SIGNATURE: Dater /j- r
Please return completed form to: 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.
Mandy Buchholz
From: Val Barschaw
Sent: Wednesday, October 18, 2017 10:17 AM
To: Mandy Buchholz
Cc: 'Dan Hansberry'; Steve Cordero
Subject: Council Recommendation
Good Morning,
Today the Law & Justice Council unanimously approved the recommendation for Jackie Herum to serve on the Law &
Justice Council as a Citizen at Large.
Would you kindly let me know the approved process to get this information to the BOCC for her consideration?
Thank you,
Val Barschaw, Kittitas County Clerk
205 West 5th Ave, Suite 210
Ellensburg, WA 98926
(509) 962-7531
NOTICE: The information provided herein is not to be construed as legal advice. Per RCW 2.32.090 the Clerk's Office is strictly prohibited from providing legal
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