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�► <br /> 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: <br /> Conflict of Interest is defined as the participation in any activity,recommended aetion, <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 interest in 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 /> � �� -/�' a�ad <br /> Applicant Signa e 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: citvhall(c�pecLuotlakes-mn.� <br /> Website: www.pequotlakes-mn.� <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:Vldministration\City C1erk�Boards and CommissionsWpplication Process and Forms�Forms�P,pplication Form for Boards and Commissions.doc <br /> Page 3 <br />