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CIVIC AND COMMUNITY ACTIVITIES: <br /> Describe past or present civic and/or community activities that may be relevant in qualifying you to <br /> serve on this b''oard or commission. •- '•;-,r ;.i �► �("; jL y Iricw i Zy-1 , ,et <br /> LLF i✓ G CI L,3 b'1 C�('. � J c -l'7 U-o <br /> l�h ,-r k72 r v 9.0 rr�r n erce, -(0 O ckikin !�c Esc et,. �� c) J <br /> r�cw k:)Cr) C:� tr► ery 1 ' r� = �v`{.E I ce.f° •-N & al:.Z, (,L.��1� <br /> z+hc:,c �L7� y i,lr`a�'��`j Lu ✓�'1 rY'7 j tl,Z l" w1'1 C ,-- C,.l(.i(.4I(,.ti-C �'1-jem <br /> ATTENDANCE: <br /> Are you aware of the importance of regular meeting attendance including the time commitment <br /> involved in preparing for meetings, and do you feel you have the time available to be an active <br /> participant: X Yes No <br /> Comments: <br /> CONFLICT OF INTEREST: <br /> I wish to disclose the following potential conflicts of interest that may or will arise if I become a <br /> member of this commission. <br /> \,1 ice'\ I /22/CP <br /> Signature Dtte <br /> THANK YOU FOR YOUR INTEREST IN SERVING ON THE PARK BOARD <br /> OFFICE USE <br /> Return Application To: Appointed To: <br /> City of Pequot Lakes Date Appointed: <br /> City Clerk's Office <br /> 4638 County Road 11 Term Length: <br /> Pequot Lakes, MN 56472 <br /> Phone:218-568-5222 Page 2 <br /> Fax:218-568-5860 <br />