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a) City of Tukwila <br />Tukwila City Hall Email: <br />O2OOGouthconherBlvd VVmbode: <br />Tukwila, WA 08188 <br />Phone: (206) 433-1800 Fax: (206) 433-1833 <br />' <br />Application fnF Appointment <br />^ <br />����Fl��0��F~/�010T|���/��� <br />��^'~��'"`���""""��^^�'`� <br />Please complete the ENTIRE application form. Applicants may attach a cover letter and/or a resume <br />totaling nomor �anthrenpmgeo <br />~ . 17Jon'2017 <br />]��[VV@ ]�S�'�� ] <br />�AK1E�~ Jessica <br />~ <br />Last HnX M.I. <br />TU�m|� �A1AA <br />AD�RESS Tukwila �`~'~~ <br />Street City Zip <br />MAILING ADDRESS (if diffemnt): <br />HOME PHONE: CELL/MOBILE PHONE. <br />��Fl�� ��|n�8| | | �� <br />BNPLOYE��~~�~'^ Global, ��~^ E4MN <br />Please check all that apply to you within the City of Tukwila limits: <br />El Resident [] BusineaaUwner/Ropraeentotive <br />[] School District Representative El High School Student <br />I wish to be considered for appointment to the following board or commission (check all that apply): <br />121 Other/Special Committee: Public <br />BOARDS & COMMITTEES: <br />[] Community Police Advisory <br />[] Human Services <br />O Library <br />[l Lodging Tax <br />HAVE YOU PREVIOUSLY SERVED ON ONE OF THESE BOARDS OR COMMISSIONS? [21 Yes 0 No <br />If ,yes,. please list: RFAAnnaxo[k7n Steering Committee, Fire Chief Interview Panel <br />AVAILABLE TO ATTEND MEETINGS: 0 Daytime 121 Evenings <br />Please contact me regarding other City of Tukwila volunteer opportunities (check box): [] <br />FOR CITY USE ONLY: <br />INTERVIEW DATE: APPOINTED: 0 Yes El No TERM EXPIRES: <br />El <br />Arts <br />O <br />Civil Service <br />[] <br />Equity &Diversity <br />U <br />Parka <br />[] <br />Planning <br />121 Other/Special Committee: Public <br />BOARDS & COMMITTEES: <br />[] Community Police Advisory <br />[] Human Services <br />O Library <br />[l Lodging Tax <br />HAVE YOU PREVIOUSLY SERVED ON ONE OF THESE BOARDS OR COMMISSIONS? [21 Yes 0 No <br />If ,yes,. please list: RFAAnnaxo[k7n Steering Committee, Fire Chief Interview Panel <br />AVAILABLE TO ATTEND MEETINGS: 0 Daytime 121 Evenings <br />Please contact me regarding other City of Tukwila volunteer opportunities (check box): [] <br />FOR CITY USE ONLY: <br />INTERVIEW DATE: APPOINTED: 0 Yes El No TERM EXPIRES: <br />