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<br />CASS COUNTY GOVERNMENT <br />APPLICATION FOR BOARDS AND COMMISSIONS <br /> <br />RECEIVED <br /> <br />OCT 28 2008 <br /> <br /> <br />CABS COUNTY COMMISSJON <br /> <br />Legislative District Number <br /> <br /><l\s1-N c, 1- B <br />State Zip Code <br /> <br />EDUCATION AND GENERAL QUALIFICATIONS <br />LEVEL NAME OF SCHOOL <br /> <br /> <br />No. Years <br />Attended <br /> <br />Major Course(s) <br />of Stud <br /> <br />High School <br />College <br /> <br />TI'8Se!liIijeiR8eelCeFF88f)eflSel'lee <br /> <br />Indicate Dates Held <br /> <br />L Co <br />eJhJ(Q{Jpo... rCl-~ - ~V'eJ-(J.j1r- C~\rre4"r~ <br /> <br />Memberships in Organizations <br />and Offices Held <br /> <br />Indicate if Past or Present <br /> <br />PrOG1~1 W\ e V" err ~"""" 0 <br /> <br /> <br />Volunteer Activities <br /> <br />Your Special Skills and <br />Qualifications <br /> <br />.P-vL -tbV'M ) It\.. OL c.om-ettr- - &({J)-71tt 5cl'\ffUJ;{f- 5>6 [t5 <br />- IfoN\ tV'e.~cJL '\- ()Cl.4\. ~\I\.\L "Jt ~ 'fiLL BcK. <br /> <br /> <br />ou have known for at least one ear <br />PHONE NO. <br /> <br />Years <br />A uainted <br /> <br /> <br />I certify that the facts contained n this application are true and correct to the best of my knowledge. I authorize investigation of all statements contained <br />herein and the references listed above to give you any and all information concerning my qualifications and any pertinent information they may have. <br />personal or otherwise. and release ail parties from all liability for any damages that ma u from furni~ the same to you. <br /> <br />RETURN COMPLETED FORM TO: SIGNATURE JJv <br />Cass County Commission <br />PO Box 2806 DATE <br />Fargo ND 58108-2806 <br /> <br /> <br />(Please attach a copy of your resume') <br />