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Attendance: Are you aware of the imgortancc of regular meeting aftendance including <br />the time commitment involved in preparing fQTjneetings and do you feel you have the <br />time available to be an active participant?_4 Yes No <br />rKJ <br />li-5 <br />Conflict of Interest is defined as the participation in any activity, reconnnended action, <br />or decision from which the individual has or could have the potential to receive paraonal <br />gaup, whether it is direct or indirect. In amor&= with thus definition, do you tune any <br />legal or equitable intmV in any business which could be consfimed as a conflict of <br />interest? Yes No <br />If yes, provide details on a separate piece of paper. <br />/ / /:I VII <br />- � 1/ / <br />Daft <br />Questions may be directed to the City Adminigration Office at 218-%&5222. <br />Return Completes) Application to: City of Pequot Lakes <br />City Administrator <br />4639 Main Street <br />Poquot Lakes, MN S6472 <br />E-mail:-„i;j„hall(utnequotlakes-mn.kov <br />Website: www-PMotlakcs-mn.gov <br />OFF[CZ USX ONLY <br />The Appteaat W New Applicant APfo for Reappsiaat <br />Cou idl Ac im; Not A"ab e@ <br />Appointed to. _ <br />Daft Appoin ted- <br />Tem Rxphvc <br />S.�tCmy CW6Bm& god C0-WWMppN *j m PMCM ad FolarTm=%AmW*%nPan f. Bm&.d auoedr =,.d, <br />Page 3 <br />