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City of Tukwila <br />Tukwila City Hall <br />82OOSouthoenterBlvd <br />Tukwila, WA 08188 <br />Phone: (206) 433-1800 Fax: (206) 433-1833 <br />Email: <br />VVebeke: <br />Application Appointment <br />��8��[l�� �yJ[� ��/�y�yNI��|(��J� <br />BOARDS ~��^' , `.��� ^^��."","����.�~."�^ <br />RECEIVED <br />Please complete the ENTIRE application form. Applicants may attach a cover letter and/or a resume <br />totaling no more than three pages. 02/28/2017 <br />Last <br />ADDRESS <br />Street <br />MAILING ADDRESS (if differe <br />8nH[eVV <br />First <br />7-Ukm''|B <br />City <br />.0 <br />ZE <br />HOME PHONE: CELL8NO8|LEPHON <br />���|f��0�|�y�p� <br />EKdPLOYER^' " ^— ' ' ~ ~~ E-MAIL <br />Please check all that apply hm you within the City of Tukwila limits: <br />E1 Resident E] BuninessOwnor/RapresentaUve <br />[] School District Representative [] High School Student <br />| wish to be considered for appointment to the following board orcommission (check all that apply): <br />BOARDS &COMMITTEES: <br />[� <br />Community Police Advisory <br />[] <br />Human Services <br />[] Library <br />0 Lodging Tax <br />El Other/Special Committee: Public Safety Bond Financial Oversight Committee <br />HAVE YOU PREVIOUSLY SERVED ON ONE OF THESE BOARDS OR COMMISSIONS? 0 Yes 0 No <br />If "yes", please <br />AVAILABLE TO ATTEND MEETINGS: U Daytime 121 Evenings <br />Please contact me regarding other City of Tukwila volunteer opportunities (check oox: [] <br />FOR CITY USE ONLY: <br />INTERVIEW DATE: AppmwrEo: [],e E] No TERM EXPIRES: <br />O <br />Arts <br />O <br />Civil Service <br />[] <br />Equity &Diversity <br />LJ <br />Parks <br />[] <br />Planning <br />BOARDS &COMMITTEES: <br />[� <br />Community Police Advisory <br />[] <br />Human Services <br />[] Library <br />0 Lodging Tax <br />El Other/Special Committee: Public Safety Bond Financial Oversight Committee <br />HAVE YOU PREVIOUSLY SERVED ON ONE OF THESE BOARDS OR COMMISSIONS? 0 Yes 0 No <br />If "yes", please <br />AVAILABLE TO ATTEND MEETINGS: U Daytime 121 Evenings <br />Please contact me regarding other City of Tukwila volunteer opportunities (check oox: [] <br />FOR CITY USE ONLY: <br />INTERVIEW DATE: AppmwrEo: [],e E] No TERM EXPIRES: <br />