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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 />Application for Appointment <br />BOARDS AND COMMISSIONS <br />RECEIVED <br />APR 0 9 2018 <br />Email: BoardsCommstukwilawa.dov <br />Website: wwvv.tukwilawa.00v <br />Please complete the ENTIRE application form. Applicants may attach a cover letter and/or a resume <br />totaling no more than three pages. <br />DATE: <br />NAME: CI \(e iliodebo1/451 57it,t (0 if\ <br />Last First <br />ADDRESS <br />461 <br />MAILING ADDRESS (if different): <br />HOME PHONE: CELL/MOBILE PHONE <br />EMPLOYER: Mao/5 <br />Please check all that apply to you within the City of T <br />1M Resident 0 Business Owner/Representative <br />0 School District Representative 0 High School Student <br />E-MAIL: <br />I wish to be considered for appointment to the following board or commission (check all that apply): <br />COMMISSIONS: <br />O Arts <br />Civil Service <br />O Equity & Social Justice <br />0 Park <br />0 Planning <br />0 Other/Special Committee: <br />BOARDS & COMMITTEES: <br />. Community Police 3 <br />13: Human Services :Jo\ <br />O Library <br />O Lodging Tax <br />HAVE YOU PREVIOUSLY SERVED ON ONE OF THESE BOARDS OR COMMISSIONS? 0 Yes V.No <br />If "yes", please list: <br />AVAILABLE TO ATTEND MEETINGS: %Daytime >1 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 0 No TERM EXPIRES: <br />7 <br />