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Home My WebLink AboutApplication 04/04/2014 w PORTANGELES 4 20M A2, «, w A s H i ry G r cr N, U. S. A. y ��: w� € hP � f S s Cu lk l �i ��xt l � C C APPLICATION FOR APPOINTMENT TO BOARD, COMMISSION OR COMMITTEr Board, Commission or Committee to which you are seeking appointment: �(" ia.'.° �.�� aM^ � ,�<� T�;7a�,t¢,�yra�.' �rd •d (._Sa? +)'1r�'t f"b�l"a <' ." lr �/�r e,a""... c'�r"Y �'"��"��,�,5 et ,?'..)t"b:�, Y ,'c�"�'°� Applicant Name and General Information ,x First NII Last Home Street Address C? rn. City C, State Zip Home phone Work phone Cell phone 0 T)0c)��.. � ( „) ( J ,fln •C.-o °\ E-mail address Date of Birth (to be completed only by applicants for Public Safety Advisory Board for purposes of criminal history check to ensure compliance with Port Angeles Municipal Code 2.26.020) Certification and Location Information (circle one) Are you employed by the City of Port Angeles? Yes (No Are you a citizen of the United States. Y. y � �,, es) No Are you a City resident? Yes No ) If so,how long Do you own/manage a business in the City? Yeso. Do you hold any professional licenses,registrations or certificates in any field? Yes o If so,please list: :_ l I Margaret E. Roth 3042 Mount Pleasant Road Port Angeles,Washington 98362 (360-467-9297) (360-460-0802) mroth@olypen.com Northwest Duty Free 115 East Railroad Ave, Port Angeles,Washington 98362 April 1993 to October 2008 Contact:Terry Roth(360-477-1019) Retail sales and cash register operations(high end receipts), tank deposits, and customer relations at point of sales. Inventory control, personal management (interview, hire,fire) Lrwining, background, and reference check up to Twenty people. Manage and stock a bonded warehouse con b oiled by United States Customs. Familiarity with Typical office machines, computer skills, keyboard, ten key,filing, manage and account for larelarge amounts of currency, Including foreign exchange, market high end products fro interriational suppliers, public tions. Familiar with U.S. Immigrations and Canadian Customs regulations. Training and Education High School: Graduated from Mt Rainier High Scholl 1973 Certificate of Currency: Basic First Aid,CPR Volunteer Work 4-H Leader Ciallam County Fair Board Member Bam Superintendent Civil Air Patrol Boys and Girls Steering Committee References Ginger Alexander-Director Historical Society Sequim (360-683-4826)20 years Mary Buck-President Strait Thunder(360-417-6797)4years Robert Mingram Retired (360-452-6183)20 years Are you aware of any conflict of interest which might arise by your service on a City Board or Commission? If so,please explain: No Work Experience-List most recent experience first,or attach a resume Employer Title From(M/Y) To(MIY) qJ U e-yj Izq Ue 4*10 J'2 kt�7 a- C4(6�&"m el C - 1G(Q,�, Tet Brief job description Employer Title From(MIY) To(M1Y) Brief job description Employer Title T From(M/Y) To(M/Y) Brief job description ]Education -List most recent experience first 1(�Yes No Institution/Location 0 Degree earned/Major area of study ---'��Iuatcd? � 1 11� �-4 (L a 0-,,, S Yes No InstitutioteLocation Degree earned/Major area of study Graduated? Yes No Institution/Location 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 Group's purpose/objective #of members Brief description of your participation: 4 OX" 61 d1i ; 7-e S S e a 0 t' e C 'L rL tle 6 a7t-lv 0 Sc"K)C' 1-k 'n Organization/Location Group's purpose/objective #of members Brief description of your participation: "(,' e, ,,�; ees L144 4 rt ' 2 1 46w 'L Questions Why are you interested in-serving on this particular Board or commission?., A—e- ALLI"14 1z &nyb L Is 4, Cl, What in your background or experience d ou think would help you in serving on this Board? W e 0 C 7 v ,o �Ml ole) it, 1°, 10 AIIJL� What is our understanding of the responsibilities of t particular Board or,Commission? As 4.0 ZZ. Ll 40)-ni al a", C e) Z)6 o7l k 0 Lj e- az a b oo e a,0 _tt2 CL, 'O'Vit c� i"a," _�)� 1,0 r, , 0 ing your application. C'tll�0 f- you wish to mak, regard C I&C � i"a �X"' , / 7-111 Please feel free to add additional comments 0,t S.1e ole(ted 0z) e- u_e C)art �Da Appli ignature Submit completed forms to: OFFICE OF THE CITY MANAGER TEREsA PIERCE,DEPUTY CITY CLERK 360-4174630 or tpierce@cityofpaus City of Port Angeles 321 E.5b Street PO Box 1150 Port Angeles,WA 98362 In compliance with the Americans with Disabilities Act,if you need special accommodations because-,of a physical 417.4500 so appropriate arrangements c ;ade. limitation,please contact the City Manager's office at 3 Are you aware ot'any conflict of interest which might arise by your service on a City Board or Commission? If so,please explain: Work Experience-List most recent experience first or attach a resume 7-, tv Employer Title G From(M/Y) To(M/Y) Brief job des Yription Employer Title From(M/Y) To(M/Y) Brief job description Employer Title From(M/Y) To(WY) Brief job description Education - List most recent experience first Yes Na L Institution/Location Degree earned/Maj or area of study aduated? ie,.n s Yes No Instituti4/Location Degree earned/Major area of study Graduated? Yes No Institution/Location 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 6d U4- 1-kl)l lie le&Aa,i 5 Organization/Location Group's purpose/objective #of members Brief description of your participation: Ille X 4 e, e&( G J �Z- Td O'7 �Pla 061 4im 1�) if 4)el') a it Orgarrizattion/Loc4tioA Gr6up's(orpose/objective #of members " -w Brief description of your participation: lt)ool-A' o I- -AtXk It - a 4/10 b ✓" -;9,f e e P;