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<br /> BOARDS :AND COMMISSIONS-
<br /> APPLICATION FORM (2016 - 2019)
<br /> Name: //k- /-7 'G .2, /L7//—�' Phone: (..� �J�,7l--fe', ,7"
<br /> Address: ,54"---- .522.------* -5-21-..- c-5:1e---2- ZI: V e-(e%a /4fe_..77? , -2,9-„v, >,.._
<br /> E-Mail: ��c '' .1, /,67(&01"--,d"7 Occupation: l''C- e d e© ` de1-
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<br /> How long have you been an Everett resident? .Y0 f e47,- .. --
<br /> Board(s)/Commission(s) of interest: CHIP Loan Review.Committee--Position Two, -
<br /> Citizen/Former CHIP Client
<br /> Why do you want to serve on this board/commission? �� a Ve. / 7 a /' J2
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<br /> Please provide background, experience, and qualifications that would assist you in
<br /> serving on this board/commission:
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<br /> List past or present community involvement: _5;7,7,-- .� •. ©v'c--, /7/-0` '
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<br /> Additional information may be attached.
<br /> Signature - -I,- ---
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<br /> it.rj.e.fr
<br /> Date S)/f /-
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