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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 board or commission. <br /> Charter member ofNCrow Wing County First Responders - 21 year member of <br /> EMS community <br /> Antique snowmobile club of America - 8 years <br /> several others <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: xX Yes _No <br /> Comments: I am again ready to help Pequot Lakes move and grow and <br /> become that great °little town up north . " <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 /> S' nature Date <br /> THANK YOU FOR YOUR INTEREST IN SERVING ON THE PLANNING AND ZONING <br /> COMMISSSION. <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 />