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RECEIVED <br />City of Tukwila <br />Tukwila City Hall Email: BoardsCommsa-tukwilawa.gov <br />6200 Southcenter Blvd Website: www.tukwilawa..qo <br />Tukwila, WA 98188 <br />Phone: (206) 433-1800 Fax: (206) 433-1833 <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: January 5 2017 <br />NAME: Miller <br />Last <br />ADDRESS: <br />Street <br />MAILING ADDRESS (if different): <br />7060951IF53115412M <br />EMPLOYER: City of Renton <br />Steven E <br />First M.I. <br />Tukwila 98168 <br />City Zip <br />CELL/MOBILE PHON <br />E-MAIL: <br />Please check a 1 hat apply to you within the City of Tukwila limits: <br />8 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 />6 Other/Special Committee: Public Safety Bond Financial Oversight Committee <br />HAVE YOU PREVIOUSLY SERVED ON ONE OF THESE BOARDS OR COMMISSIONS? t Yes ❑ No <br />If "yes", please list: Library Advisory Board, Tukwila Emergency Communications Team <br />AVAILABLE TO ATTEND MEETINGS: ❑ Daytime 6 Evenings <br />Please contact me regarding other City of Tukwila volunteer opportunities (check box): ❑ <br />FOR CITY USE ONLY: <br />INTERVIEW DATE: APPOINTED: ❑ Yes 1771 No TERM EXPIRES: <br />We, <br />