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NM�51,; 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: BoardsComms@tukwilawa.go <br />Website: www.tukwilawa.go <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 01 -7 <br />NAME: V'-Sny��l <br />Last <br />ADDRESS: <br />Street <br />MAILING ADDRESS (if different): <br />Prrst <br />C/k C"I., h, <br />City <br />HOME PHONE: CELUMOBILE PHONE: <br />EMPLOYER: /Oc, %i et E-MAIL: <br />Please check all that apply to you within the City of Tukwila limits: <br />$1 Resident ❑ Business Owner/Representative <br />❑ School District Representative ❑ High School Student <br />M. 1. <br />Zip <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 />❑ Sister Cities <br />❑ Lodging Tax <br />Other/Special Committee: ov"'y-si e) '--,L- <br />4-0 r -n (-,V-) I' ff-c-le- <br />HAVE YOU PREVIOUSLY SERVED ON ONE OF THESE BOARDS OR COMMISSIONS? ❑ Yes X No <br />If "yes", please I <br />AVAILABLE TO ATTEND MEETINGS: ❑ Daytime [X Evenings <br />Please contact me regarding other City of Tukwila volunteer opportunities (check box): <br />FOR CITY USE ONLY: <br />INTERVIEW DATE: APPOINTED: []Yes ❑ No TERM EXPIRES: <br />21 <br />