HomeMy WebLinkAboutNEW Application L Folsom The City of Port Angeles
Advisorl Board Application
p
Parks, Recreation and Beautification Commission
Applicant Name and General Information
Position applying for (check one): Commissioner Student Position
First MI Last
Ll A: ?'5r� Aoy,(e
Address City / State Zip
C hone __
Home Work .....� ._' .. �.
p phone Cell phone
E-mail address
Certification and Location Information
Areyou employed by the City of Port Angeles?......................................................................................................................................................................... es
Areyou a citizen of the United States?..................................................................................................................................................................................................
Areyou a Registered Voter?.............................................................................................................................................................................................................................. es
Areyou a City resident?......................................................................................................................................................................................................................................... c'a
Ifso,how long:.................................................................................................................................................................................................................................................................
Doyou own/manage a business in the City?................................................................................................................................................................................... es
Do you hold any professional licenses,registrations or certificates in any field?................................................................................ es
If so,please list:
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:
�.�� ...,,_....,,... .. .._.._._ _ ------wa ........._....................
w. �.
The City of Fort Angeles
1 tsxa ^ ,^A , AdvisoEj Board Aolpfication
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?
�.
xmmm w i?➢�� .Ww.t .� --I_: . LtWt...l�� � i ��:d.�^:.
..........
� .. ---------- ............e ----------
2. What is your favorite City of Port Angeles parks and recreation facility and why?
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?
�. ..m. �, _ ...... ... w ....... ............ ...w �__.. .._.... �. _....
Applicant Signature Date
Submit completed forms to: Office of the City Clerk Kari Martinez-Bailey'
City of Port Angeles 360-417-4634
321 East 5"Street kmbailey@cityofpa.us
Port Angeles, WA 98362
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.