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Attendance:Are you aware of the importance of regular meeting attendance including
<br /> the time commitment involved in preparin for eetings 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 interest inany business which could be construed as a conflict of
<br /> interest? Yes \No
<br /> If yes,pro 'i - d-j.. on a s- 'orate piece of paper.
<br /> :, .." , / , / ,
<br /> Ar
<br /> ' ' j I/7/0Z,
<br /> Applcan Si y i : ' e Date
<br /> Questions may be directed to the City Admini•tration Office at 218-568-5222.
<br /> Return Completed Application to: City of P'. of Lakes
<br /> City Administrator
<br /> 4638 Main Street
<br /> Pequot Lakes,MN 56472
<br /> E-mail: cityhall@pequotlakes-mn.gov
<br /> Website: www.pequotlakes-mn.gov
<br /> 7/11,,,,,,p//,,, ,,„ ii c 1 r,;) )i'E ,,,,, , ,, ,,..., , „, iii i,%h ,, Jli ti <7i'1 (aNi i'i,ilii,/ ,, i/,c,,,I
<br /> OFFICE USE ONLY
<br /> The Applicant is: X New Applicant Applying for Reappointment
<br /> Council Action: Not Appointed
<br /> X Appointed to: ` R
<br /> Date Appointed:
<br /> Term Expires: i 2/ 31 I 2.0V-i
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