HomeMy WebLinkAbout06/16/2009 03D Brian Johnson Appointment to the Housing Authority Board 3,1 Z.
CITY OF YAKIMA R L " I'I D
BOARDS AND COMMISSIONS
4110 APPLICATION '09 JUN -5 P 1 50
We appreciate your interest in serving your City in this capacity. We ask you to complete this brief form to
help provide the City Council with sufficient information to make an ap 11ff I1 tpgt 9f f 6�s , board or
commission of the City of Yakima. AA{�'11
A. Please Print Clearly:
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NAME: (Mr., Mrs., Ms.) //9/d .. /7//(; ZW
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HOME ADDRESS: /490/ .A 4 *km. /4 9W
Number Street / �/ / ` / /
Apt. City Zip Code.
PHONE NUMBERS: ( ∎O9l 11 9 ?/n6 / �o /(/ 7 ?h.7 6137 C Le f 6 9
�
o��� .6.-C Business Other (Specify)
E -MAIL: v D JO,/t4 (2A � `_ L.t�/r - k, A/E FAX '/7/
YAKIMA RESIDENT: YES g NO ❑ If Yes, number of years 6% t/
B. Please number the board(s), commission(s) or committee(s), etc. in the priority in which you are
interested.
Air Terminal Board Housing Loan Review Committee *
Bicycle/Pedestrian Advisory Committee Yakima Historic Preservation Commission *
Board of Appeals Parks and Recreation Commission
I Charter City Employees Civil Service Commission Police and Fire Civil Service Commission
• Capital Improvements / Facilities Committee Public Facilities District Board
Commercial Revitalization Deduction Regional Yakima Urban Area Re l Plannin Commission
Review Committee g Planning
Community Review Board * . Other—
/ I
Housing Authority Board
*Additional information requested for representation requirements:
Community Review Board: Representation (local resident, health community, residential rental community, building industry
or business community):
Housing Loan Review Committee:
Business Name/Location
Yakima Historic Preservation Commission: Please complete supplemental form
C. Available for day meetings: b Available for evening meetings: ❑
ID STDC Br ds&CmmApplication.doc -- 6/30/2008
D. Please give any training or experience that you possess which would be beneficial to a member of the
board or commission in which you are interested:
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E. Special reasons for wishing to serve on this Commission- O
F. Have you ever served on any other board or commission? If so, please state city, state, dates, and name of
board or commission: 1 ///� ✓ Cr) ...E r — /K) 4, i/e t/P /LI . t►f .6 '. , (-i, : /t - a i/ll
. /l &A /wc r - fir e :a ! q)e
G. Please furnish two references who can speak to your qualifications for the desired appointment:
NAME: ,C /,(1 6,-5
ADDRESS:
qq ?--7-6'
Zip Code
DAYTIME PHONE NUMBER: )
NAME: LC3 . !_?Jtgn (� /cDFLL 4k/iv/ I ADDRESS: - zJ C._d/ 'A r-r 4 .D z
Zip Code
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DAYTIME PHONE NUMBER: 7 \-3 ) p '.7e i73
When a vacancy occurs on a board or commission in which you have indicated an interest, your application will
be provided to the Council Committee. The Committee will then make a recommendation to Council for
appointment. The Council Committee or the City Council may desire to conduct an interview.
This application is subject to public disclosure. Your residential address and residential telephone number are
personal information which would violate your right to privacy and may be exempt unless you authorize full
disclosure. '
Authorize full disci 1 r• • y es' �� ■ o ❑
Your Signature: (_ L_ ', . 4 .. _ _ -- Date: ,-, j
Please return completed form tot akima City Clerk, 129 North 2nd Street, Yakima, WA, 98901. Applications
will be kept on file for one year. (If you have any questions please call 575- 6037.)
A brief description of the purpose of the boards, commissions and committees, etc. can be found on -line at
http: / /www.ci.yakima.wa.us /council/ under Boards and Commissions, or call for information.
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STDC Brds&CmmApplication.doc -- 6130/2008