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AU[-10-2006 15:24 WINDERMERE/EVERETT SOUTH 338 9600 P.02 <br /> • ..t `�^,1 a\AjWn�' ,� A lt,,r r,.a.i1 J,!� ',; •1 i �� ,r�1,:���:1 <br /> . BOARDS AND CO sss 'g- • . <br /> APPLICATION FORM <br /> Name: �� 6,141i K1JLt - -- <br /> Address: tM?61 t'�"1 11 ' I%e q?W( <br /> Phone: ti25--2C-9- 07 76 2 7mQ 4Z5--- 9d-- I q41• <br /> Occupation: 'ai-(,r{ — <br /> How long have you been an Everett resident? _19_6_9- <br /> 9_6_ <br /> Board(s)/Commission(s) of interest: Animal Shelter Advisory Boards <br /> Whydoyou want to serve on this board/commission? 1S� OF - C <br /> i t , , 4 , • IA 111114 Its l r LA <br /> C3 �� <br /> 4. '. f ice 1 ke'fi;. f da .44A A •' ►i�• t 4 11 a tik/•i <br /> Please provide background,experience, a d qualifications thatld assist you in <br /> serving on this board/commission: S _ N1 q <br /> 1 0041]01,G41'�1adrm <br /> J <br /> 601/8.8. , I [etti k 61 p. I 1 , , Pt , 4 <br /> R 1 • (r /i <br /> 4 ,t r/ (t' + ' ' d , 01 of ad !! MIL.,.A1. . , 4 ',L- ' 1 <br /> I ,� <br /> List past or present community involvement: tat, 1 U'e,�l 4 J <br /> C - e hi__ rlh-.P 171 biriies _k?/kPettri7sapt_,.0_1,11 /- <br /> --coe 44 1 St, . - r 4+ f4 • ...it'd. t .. IL er i <br /> fig <br /> rtAA <br /> LC ¢,a. ' , - , ' ' -L.600--e.A____ <br /> Additional information may be attac•ed <br /> Signatu ir.lt� <br /> r ti:7(44,,A <br /> rrr <br /> Date 0 l , 3, <br /> TOTAL P.02 <br />