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Attendance: Are you aware of the importance of regular meeting attendance including <br /> the time commitment involved in preparing for meetings and do you feel you have the <br /> time available to be an active participant?�Yes No <br /> Comments: lX'� p vn ry,i l�r� .� � �e /'K X/�Ca �.•1-�C 6 <br /> a c�.� <br /> � <br /> , ,� . <br /> Conflict of Interest is defined as the participation in any activity, recommended action, <br /> �r decisifln fram which the individual has or cauld have the potentiai to receive persor�al <br /> gain,whether it is direct or indirect. In accordance with this definition, do you have any <br /> legal or equitable interest in any business which could be construed as a conflict of <br /> interest? Yes �l No <br /> If yes,provide details on a separate piece of paper. <br /> ��- 5'�l� <br /> App ic ignature Da e^ <br /> Questions may be directed to the City Administration Office at 218-568-5222. <br /> Return Completed Applicatian to: Ciry of Pequot Lakes <br /> City Administrator <br /> 4638 Ma.in Street <br /> Pequot Lakes,MN 56472 <br /> E-mail: <br /> Website: <br /> OFFICE USE ONLY <br /> The AppHcant is: New Applicant Applying for Reappointment <br /> Council Action: Not Appointed <br /> Appointed to• <br /> llate Appointed: <br /> Term E�pires• <br /> S:�rldministration\Ciry C1crk�Boazds and Comtnissions\Applica[ion Prcxess and Fo�ms�Foims\Application Form for Boards and Commissions.doc <br /> Page 3 <br />