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10.02B HRA Commission Appointments
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01-07-2020 City Council Meeting
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10.02B HRA Commission Appointments
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Attendance: Are you aware of the importance of regular meeting attendance including <br /> the time commitment involved in preparing€o�meetings and do you feel you have the <br /> time available to be an active participant? �� Yes No <br /> Comments: <br /> Conflict of Interest is defined as the participation in any activity,recommended action, <br /> or decision from which the individual has or could have the potential to receive personal <br /> gain, whether it is direct or indirect. In accordance with this definition, do you have any <br /> legal or equitable interes m any business which could be construed as a conflict of <br /> interest? Yes �No <br /> If yes,provide details on a separate piece of paper. <br /> ��� /, J � <br /> � <br /> Applicant Signature Date <br /> Questions may be directed to the City Administration Office at 218-568-5222. <br /> Return Completed Application to: City of Pequot Lakes <br /> City Administrator <br /> 463 8 Main Street <br /> Pequot Lakes, MN 56472 <br /> E-mail: nmalecha�n,pequotlakes-mn.gov <br /> Website: www.pequotlakes-mn.�ov <br /> OFFICE USE ONLY <br /> The Applicant is: New Applicant Applying for Reappointment <br /> Council Action: Not Appointed <br /> Appointed to• <br /> Date Appointed: <br /> Term Expires: <br /> S Wdministradon\City Clerk�Boards and Commissions�Apphcation Process aud Forms�Fortns�Application Form for Bo�rds and Commissions doc <br /> Page 3 <br />
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