Laserfiche WebLink
I <br /> : .........C- I..:....... .:....:O.....:..F..__.._E:.......:...:.............,;-._:.::-::.::-: � ; < � = >> sp < -i ' >. - ' <br /> ,: - :: <br /> OA <br /> COMMISSIONS'.ST <br /> APPLICATION FORM (2016 - 20 19) <br /> Name: /k�/36- I , ��� '�7 Phone: (J��,'-Jam,,-�.a ,7' <br /> Address: _* 4_,d--= .52',. v`;� . 2� V e_r%a /Z./ /9 P��Z-5.._ <br /> E-mail: ��e Jac' ey e7r.:L:7f'J m Occupation: t'c.74i%'e ;-',1%.‘/--.".'21- G/1- - <br /> y /he,.r7.. 6-e'ji-, <br /> How long have you been an Everett resident? d e ,--..�- <br /> Board(s)/Conxznission(s) of interest: CHIP Lean Review Committee—Position Two - <br /> Citizen/Former CHIP Client <br /> Why do you want to serve on this board/commission? ,._.C7%a v . � � a /,c2r) <br /> r c//�:'�.r,z4 a/..I // y©. ..,�{ 1.e._ ,/ dy�/?� , .Z. , /, <br /> Please provide background, experience, and qualifications that would assist you in <br /> serving on this board/commission: '/ / <br /> .., G' /.-i a.S. Cie--7, e,/ ,(-.1-c-;` yL7 i e_.`"/ `"G! e-f9 .2/ G�1/ ' i <br /> s '-s..,"--&_/--,/ e r` /Cr..S" ..SS : i !.1 /S////. /f ,lf i 7G•G) ' <br /> e o7/7 1/ 4.-.../..7"---"G `he--,/moi .i ) ...--,Lv ./- ..2: ` /, ._Er , <br /> List past or present community involvement: .5,,-?,3 - 46©v'c-- ,, /57:7-5't.4'/2 A2DF.-7 - J �rr� ,-- - 2. p ,22,--1 .e- / ; <br /> Zit& fie ,-Z .2 e 7 c/- ",2 62,1/..._._.i „ <br /> Additional information may be attached. <br /> 46.77, Signature -.I,. G�-��.�._� <br /> Date / 1f Z <br />