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12-18-90 CCM
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12-18-90 CCM
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2/4/2025 7:00:38 PM
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lL . <br />I <br />APPLICATION FOR APPOINTMENT TO AN ADVISORY COMMITTEE, <br />COMMISSION, OR DISTRICT WATERSHED <br />COMMITTEE <br />INSTRUCTIONS: <br />I. Please see back of thisfonnfor a list ofAdvisoty Committees/Commissions in <br />Washington County, and enter the committee name for wbicb you are applying in <br />the space above. <br />2. Please complete one application for each committee appointment you are seeking. <br />(Please Print) <br />Last <br />ADDRESS: <br />Street City <br />PHONE: <br />Horne <br />First <br />State <br />Zip <br />Middle <br />Business <br />IN WHICH COMMISSIONER DISTRICT DO YOU RESIDE? <br />LIST EXPERIENCE OR SKILLS YOU HAVE RELATING TO THE APPOINTMENT YOU ARE SEEKING: <br />LIST SPECIAL OR PERSONAL INTERESTS YOU HAVE RELATING TO THE APPOINTMENT YOU ARE SEEKING: <br />WHY DO YOU WANT THIS APPOINTMENT? <br />RETURN THIS APPLICATION TO: <br />WASHINGTON COUNTY <br />Office of Administration <br />Government Center <br />14900 61st Street North <br />Stillwater, MN 55082.0006 <br />(612) 779-5401 <br />LIM 9gnatureofA(pk'unu <br />
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