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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: <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 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 />Applicant Si re <br />Y z� .r? L` <br />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: cityhallftequotlakes-mn.gov <br />Website: www.peguotlakes-mn.gov <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 />SAAdministration\City ClerkWoards and Commissions\Application Process and FormsTorms\Application Form for Boards and Commissions.doc <br />Page 3 <br />