HomeMy WebLinkAboutHull Application, APPLICATION FOR APPOINTNIENT AUG 14
TO KITTITAS COUNTY BOARDS & COMMISSIONS
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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 & is subject to Public Disclosure.
PLEASE PRINT CLEARLY.
BOARDS OR COMMISSIONS FOR WHICH YOU WOULD LIKE TO BE CONSIDERED:
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List any specific seat you are interested in as well as the District you reside in.
Date: —;V/3A 0
Name: GUV i o f #w /I
Business Address: 9 13 w 4f 74ve- Home Address:
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City State Zip
Contact Number: SD °1— 8IS717— 6 8 09 F
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City State
Email address: YJ w
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Education: (High school, name and location of college or university, year graduated, and degree):
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 training or experience you have that would be beneficial to serving on the Board or
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Are you available to attend board meetings during the day or evenin M -F?
If no, please explain: 'FT'1" e- rk
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Please furnish two referenc'e's who could speak to your qualifications for the desired appointment:
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■ Name: i k e. F -c /' ✓*.o-, _Phone: (D) ' 96Y YFCO (W) S°$ ' 2122-03/2-
Address:
d3/.-Address: City: r d ' State: 4,44 Zip:
• Name:10.� j ] D wtt. Sd-r Phone: (H] � ' �� r" ��°z3(Wi 20 6 "" a 3 —/39-5
Address: Citys�aL yft State: A)4 Zip:
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. We will retain your
application for 2 years from the date it is received.
YOUR SIGNATURE: Date: Is
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Please return completed form to: Board of Kittitas County
Commissioners 205 W.5th, Room 108
Ellensburg, WA 98926
509.962.7508 or bocc@co.kittitas.wa.us
PLEASE NOTE: ALL APPLICATIONS SUBMITTED TO THE BOARD OF COUNTY
CONI N1 rSSIONERS FOR APPOINTMENT BECOME OFFICIAL PUBLIC RECORDS.