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4..8'11.4 iv <br />ff <br />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 />Email: BoardsCommsatukwilawa.gov <br />Website: www.tukwilawa.dov <br />Please complete the ENTIRE application form. Applicants may attach a cover letter and/or a resume <br />totaling no more than three pages. 10-8-18 <br />DATE: <br />NAME:Stark <br />ADDRES <br />Last <br />Street <br />MAILING ADDRESS (if different): <br />HOME PHON <br />Dixie <br />First <br />Tukwila <br />A <br />M.I. <br />98168 <br />EMPLOYER:Dixie Stark Interiors <br />City <br />CELL/MOBILE PHON <br />E-MA <br />Zip <br />Please check all that apply to you within the City of Tukwila limits: <br />0 Resident 0 Business Owner/Representative <br />0 School District Representative 0 High School Student <br />I wish to be considered for appointment to the following board or commission (check all that apply) <br />COMMISSIONS: <br />BOARDS & COMMITTEES: <br />0 Arts 0 Community Police <br />0 Civil Service 0 Human Services <br />0 Equity & Social Justice 0 Library <br />D Park 0 Lodging Tax <br />el Planning <br />El Other/Special Committee: <br />HAVE YOU PREVIOUSLY SERVED ON ONE OF THESE BOARDS OR COMMISSIONS? El Yes 0 No <br />If "yes", please list: <br />AVAILABLE TO ATTEND MEETINGS: 0 Daytime 0 Evenings <br />Please contact me regarding other City of Tukwila volunteer opportunities (check box): 2 <br />FOR CITY USE ONLY: <br />INTERVIEW DATE: APPOINTED: Li Yes CI No TERM EXPIRES: <br />11 <br />