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Attendance:Are you aware of the importance of regular meeting attendance including <br /> the time commitment involved in preparin for meetings and do you feel you have the <br /> time available to be an active participant?�Yes No <br /> Comments: <br /> Conflict of Ioterest 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 inter s any business which could be construed as a conflict of <br /> interest? Yes ��No <br /> �� J� �-- cv�r�k c._ GI t e� �,.�-S 5�r� � V�'���^c L. �- Wot�k� <br /> If yes,provide details on a separate piece of paper. ('��v� �� <br /> � <br /> . A:�_ �� � ���- ��a� <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 /> 4638 Main Street <br /> Pequot Lakes,MN 56472 <br /> E-mail: cityhall_nn,pequotlakes-mn.� <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 Eapires: <br /> S:Wdministration�City Clerk�Boards and Cowmissions�Application Procoss and Foims�Forms�Appiication Form for Boec,ds and Commisaiona.doc <br /> Page 3 <br />