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E <br />ADVISORY BOARD, COMMITTEE, COMMISSION & DISTRICT WATERSHED <br />Audit Committee <br />Housing & Redevelopment Authority <br />Planning Advisory Commission <br />Board ofAdjustment&Appeals <br />HbratyBoard <br />PrivatelndtvmyCotmdl <br />CommunityConecdonsAdvisorylinatd <br />Mental Health Advisory Council <br />` <br />*PubllcHealth Advisory Committee <br />CommunitySodalSetvict AdvisoryCommittee <br />Minnesota Extension Committee <br />Regional Rail dtkensAdvisory <br />ErnetgencyMedicd Services Council <br />Park& Open Space Commission <br />Solid Waste Advisory Commission <br />Historic CourthouseAddsoty Committee <br />Personnel Board of Appeals <br />*ewatershed DistrictAppointment <br />*ifyou are interested in appointment to the Public Health Advisory Committee, please complete <br />the following information: <br />1) Are you or is your spouse a licensed or credentialed health professional? Yes_No— <br />If yes, in what area is your license or credential? <br />Myself: <br />Spouse: <br />2) Are you currently employed by or representative of a licensed or certified health care <br />institution or agency, health care insurer or health professional school? Yes — <br />No - <br />If yes, please indicate the name of your employer or the agency you represent: <br />3) Do you have a financial interest in the provision of health services? Yes_No— <br />**If you arc interested in appointment to a Watershed District Board of Managers, you must be a <br />resident of the Watershed. Watershed Districts in Washington County are: <br />Carnelian -Marine <br />Ramsey -Washington <br />Rice Creek <br />Valley Branch <br />Watershed <br />Metro Watershed <br />Watershed <br />Watershed <br />Iluga <br />lake Elmo <br />Birclwuod <br />Afton <br />GrantTownship <br />Lnndfall <br />DellmW <br />Lake Elmo <br />May Township <br />Oakdale <br />ForestLake City <br />Mahtomcdi <br />Nt Scadia7'ownitip <br />Woodbury <br />litga <br />Oakdale <br />SuliwAffTownship <br />Mahtomedl <br />Pine Springs <br />White Bear Lake <br />St. Marys Point <br />Willernle <br />Woodbury <br />Forest Like Township <br />Bayta 1lownship <br />GrantTownsbip <br />GrnntTownship <br />MtyTownship <br />West Lakeland Township <br />NewSc ndiaTowrship <br />Washington County does not discriminate on the basis of race, color, national origin, <br />sex, religion, age and bandicaly ed status in employment or the provision of services. <br />