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RECEIVED <br /> SEP 11 2014 <br /> CASS COUNTY COMMISSION <br /> CASS COUNTY GOVERNMENT <br /> APPLICATION FOR BOARDS AND COMMISSIONS <br /> roof Comets • for witch you are appyuts Pre.a/ <br /> i <br /> Y•UR NA E(Last Fret,Middle) County L.gslitry District Nunbar <br /> u . /..ref/ /46 -.Ss <br /> Mailing Address City State Zip Cods <br /> SD I , '� G)A _e . / .57/14 <br /> • Business Phone Number A Residence Phone Number <br /> -.r%. . -4174 _,.L _0_ _ / ` <br /> Employer Name <br /> E <br /> . / mil terc let4. 9 �J <br /> call/ <br /> Stew i Zw Code <br /> EDUCATION AND GENERAL QUALIFICATIONS <br /> LEVEL NAME OF SCHOOL LOCATION No,Yews Oil You Major Comets) <br /> Attended Greduea+ or same <br /> >{pt+School /Wry <br /> Coma. II lif) T �1 �2 )TrttthNBuMrras9lConssperndurirw*ST �� MISfaSeolt CPI y Nti0/1/4 <br /> d� aOrganizations � r ym ev #,' 4tt D e4CS Oridalliticpad <br /> Indicate Dales Held r A' /11/1145 r�a� /r f Aoet oefL.W7/61 <br /> Volunteer Activities <br /> Indicated Pest se Present PM AL bt'7 S4/ J B44,4D <br /> Vat canon Sulks and / 601G7e'a•"�''�t- <br /> Owldraalrorts <br /> REF:R rI three• • . not related to •u whom • have known for at least one <br /> NAME •• PHONE NO - <br /> r' i► '!:1.LJ ia =1,1 Q/' . ,- <br /> t eerily that the rags c nnamai m era applcMan we bus and ernes to do beat d my tamwlsdpe I.umonse rweeecan at ee rramwas ooraaened <br /> hewn and du rataranaw Wed stew to Ow you any and at rnlormabon oonoanvng my rasMtresserr and any mew*wf anmaeue they mayhem <br /> omens or eererw...and ntaw as vas•horn m Rally tar any Oatmeal that may maul h.rntbrrrufe you <br /> f ETU IVI C PLEETTEO FORM TO SIGNATURE I/I%AWL _ <br /> PO soh 2900 DATE /,/,/, <br /> Fargo NO 09109.2•09 <br /> (Pleams attach a copy of your rooms') <br />