HomeMy WebLinkAboutBailey Application 09/13/2018Parks, Recreation and Beautification Commission U U I 3r -r I 'j "I'll LJ
CITY OF PORT ANGELES
Applicant Name and General Information
First Mi Last
City
Certification and Location Information
Areyou employed by the City of Port Angeles? ..................................................................................................................................................................
Yes
Areyou a citizen of the United States? ...........................................................................................................................................................................................
es) No
Are you a Registered Voter? ................... .................................................................................................................................................................................................
Yes No
Areyou a City resident? ............................................................................................................................................................... ................................................................
(Yes No
Ifso, how long: ......................................................................................................................................................................................................................................
............... I I
Doyou own/manage a business in the City? ......................... ........................................................................................... ......................................................
Yes �o
Do you hold any professional licenses, registrations or certificates in any field? ......................................................
....................... Yes (:N::o"
If so, please list: V11 -11 -Pr
Are you aware of any conflict of interest which might arise by your service on the advisory board that you are applying for?
If so, please explain:
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The City of Port Angeles
1 Advisory Board Application
Work or Professional Experience - List most recent experience first, or attach a resume
Employer
Brief job description
V A
Employer
�b�ygo�
Brief job description
Employer
Brief job description
Education — List most recent experience first
Institution/Location
Institution/Location
Institution/Location
Yes
Degree earned/Major area of Study Graduated'?
Yes No
Degree earned/Major area of Study Graduated?
Yes No
Degree earned/Major area of Study Graduated?
Charitable, Social and Civic Activities and Memberships — List major activities you have participated in
during the last five years
Organization/Location
Brief description of your participation
Organization/Location
Brief description of your participation
Group's purpose/objective
Group's purpose/objective
t i ir The City of Port Angeles
Advisory Board Application
i F
Parks, Recreation and Beatification Commission Applicant Supplemental Questionnaire
1. This Commission focuses on three areas: parks, recreation, and beautification. If you had to choose, which of these three areas
would be the primary one in which your interests and experience would be aimed?
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2. What is your favorite City of Port Angeles parks and recreation facility and why?
A
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3. Think of a Port Angeles park you visit. What would you do, or like to have done, to improve your experience? What do you
love about this park`?
Applicant Signature
Submit completed forms to:
Office of the City Clerk
City of Port Angeles
321 East 5"' Street
Port Angeles, WA 98362
Date
Kari Martinez -Bailey
360-417-4634
krnbailey(q_,)eityofpa.us
In compliance with the Americans with Disabilities Act, if you need special accommodations because of a physical limitation,
please contact the City Manager's Office at 360-417-4500 so appropriate arrangements can be made.
This document and all attached information is considered a public record and may be distributed to members of the City
Council for appointment consideration. Additionally, it may become a part of a City Council packet.