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<br />02-27-'08 16:08 FROM-Cass County Jail <br /> <br />701-271-2967 <br /> <br />T-599 P002/002 F-041 <br /> <br />CASS COUNTY GOVERNMENT <br />APPLICATION FOR BOARDS AND COMMISSIONS <br /> <br />RECEIVEU <br />FEB 2 7 2008 <br /> <br />Board of Commission for which you are applying: lS"G, f DI.J I!}L, <br />S.E. ~A1JSE12VlCe.s ~kRD <br /> <br />CAS8 COUNTY COMMISSION <br /> <br /> <br />YOUR NAME (Last, First, Middle) <br />5 <br />Mailing Addre s <br />2525 38 Y2. AI/G. Soc.c:n-l- <br />Your Occupation - Title <br />G ({AN. MG R. <br /> <br /> <br />Legislative District Number <br />41 <br />state Zip Code <br />N.b. 5810 <br />Residence Phone Number <br />MOl 37/-l::J892.! Cetf <br />2. qrg- !rJ Zetl: ho fY1~ <br /> <br />S eft <br />Zip Code <br /> <br />~ <br /> <br />EDUCATION AND GENERAL QUALIFICATIONS <br />LEVEL NAME OF SCHOOL <br /> <br /> <br />LOCATION No. Years <br />Attended <br /> <br />High School <br />College <br /> <br />J <br /> <br />Trade/Business/Correspondence <br /> <br />Memberships in Organizations <br />and Offices Held <br /> <br />Indicate Dates Held <br /> <br />Volunteer Activities <br />Indicate if Past or Present <br /> <br />Your Special Skills and <br />Qualifications <br /> <br />ou have known for at least one ear <br />PHONE NO. <br /> <br />5lDl- ~l"o <br />J.f1~-7Zoo <br />'2.'11- qJ <br /> <br />Years <br />A uainted <br />37 ttVS <br />S <br />5' <br /> <br /> <br />I certify that the facts contained in this application lilre true and correct to the best of my knowledge. I authorize investigation of all statement6 contained <br />herein and the referencel!i listed above to give you any and all information conceming m Iifications and any perti t infonnation they may have, <br />pel'$onal or otherWise, a'rld r$leall8 all parties from all liability for any damag/llS 1h y re m furnishing the Sa to you. <br /> <br />RETURN CO~PLETED FORM TO; <br />Casa County 'COmml86ion <br />PO Box 2806 <br />Fargo NO 58108--2806 <br /> <br />SIGNA TUR <br />DATE <br /> <br /> <br />(Please attach a copy of your resume') <br />