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(D City of Tukwila <br />Tukwila City Hall <br />6200 Southcenter Blvd <br />Tukwila, WA 98188 <br />Phone: (206) 433-1800 Fax: (206) 433-1833 <br />RECEIVED <br />Email: Boards C <br />2,___ o mms1&1,ty,P vv_ilaW . ov <br />Website: www.t(jkwilawg.gov <br />Application for Appointment <br />BOARDS AND COMMISSIONS <br />Please complete the ENTIRE application form. Applicants may attach a cover letter and/or a resume <br />totaling no more than three pages. DATE: 1/19/2017 <br />Castillo <br />Last <br />ADDRESS����— <br />Street <br />MAILING ADDRESS <br />Jun <br />First <br />Tukwila <br />City <br />HOME PHONE: CELL/MOBILE PHONE: <br />EMPLOYER, Group Health E-MAI <br />Lin <br />Please check all that apply to you within the City of Tukwila limits: <br />Resident ❑ Business Owner/Representative <br />School District Representative ❑ High School Student <br />I wish to be considered for appointment to the following board or commission (check all that apply): <br />COMMISSIONS: <br />❑ <br />Arts <br />❑ <br />Civil Service <br />❑ <br />Equity & Diversity <br />❑ <br />Parks <br />❑ <br />Planning <br />BOARDS & COMMITTEES: <br />❑ Community Police Advisory <br />❑ Human Services <br />❑ Library <br />❑ Lodging Tax <br />9 Other/Special committee.. Public Safety Bond Financial Oversight <br />HAVE YOU PREVIOUSLY SERVED ON ONE OF THESE BOARDS OR COMMISSIONS? [a Yes ❑ No <br />if "yes", please list: COPCAB <br />AVAILABLE TO ATTEND MEETINGS: ❑ Daytime El Evenings <br />Please contact me regarding other City of Tukwila volunteer opportunities (Check box): ❑ <br />FOR CITY USE ONLY: <br />INTERVIEW DATE: APPOINTED: ❑ Yes El No TERM EXPIRES: <br />Ni <br />