HomeMy WebLinkAbout[03c] Sara Drake, Human Rights Commissions
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BOARDS a COMISSIONS
APPLICATION iPA
APPLICATION INSTRUCTIONS:
PLEASE COMPLETE THE QUESTIONS ON THIS APPLICATION FOR OUR BOARDS AND
AND FORWARD TO:
MAFOR 'S OFFICE, 400 2ND STREET SOUTH ST. CLOUD, MN 56301
EMMANUEL.OPPONG�;CLSTCLOUD.MN. US
DATE: 5 /
ADDRESS:` 00 RWO AVLJ#AITY&JUK�P TATE:_ L)7,IP: P 7�
PHONE: (HOMEJ�' f�'0�(!2 (Q q3l (p (WORK) MFS
EMAIL: dr LCA Y CQ61'1GL� • c �I YI
9t PLEASE INDICATE THE BOARD(S) AND COMMISSION(S) ON WHICH YOU WOULD LIKE TO SERVE.
AIRPORT ADVISORY BOARD ARTS COMMISSION
BD OF EXAM. FOR MECHANICAL INSTALLERS BUILDING ADVISORY BOARD
BUILDING APPEALS BOARD CIVIL SERVICE BOARD
CONVENTION CENTER (RIVER'S EDGE) ADVISORY COMMITTEE
ECONOMIC DEV. AUTHORITY
HERITAGE PRESERVATION COMMISSION
LHUMAN RIGHTS COMMISSION
PLANNING COMMISSION
POLICE CITIZEN REVIEW BOARD
ST. CLOUD PUBLIC LIBRARY BOARD
WHITNEY SR CENTER ADVISORY BOARD
HEALTHMOUSING ADVISORY
AND APPEALS COMMISSION
HOUSING & REDEVELOPMENT
AUTHORITY BOARD
PARK & RECREATION BOARD
PLUMBING BOARD
RETIRED & SENIOR VOLUNTEER
ADVISORY BOARD
TRANSPORTATION
INFRASTRUCTURE ADV. BOARD
ZONING BOARD OF APPEALS
L PLEASE TELL US WHY YOUAREINTERESTEDINAPPLYING.
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6. PLEASE TELL US WHAT TIME COMMITMENT YOU CAN PROVIDE YOUR BOARD OR COMMISSION
BEYOND REGULAR MEETINGS.
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7. PLEASE TELL US WHAT YOU THINK YOU CAN CONTRIBUTE.
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PLEASE SIGN:
BY ACCEPTING THIS APPOINTMENT I AGREE TO ABIDE BY AND PRACTICE, THE HIGHEST STANDARDS
OF ETHICAL CONDUCT FOR PUBLIC OFFICIALS. IN PARTICULAR, I .AGREE' THAT I WILL NOT
PART'ICIPAT'E IN %NY DECISION OR, IF IN AN ADVISORY CAPACITY, MAKE ANY RECOMMENDATION,
FROM WHICH I OR MY FAMILY WOULD DIRECTLY BENEFIT PERSONALLY OR FINANCIALLY. I
I'NDF.RSTAND THAT THE APPEAR NNCF, OF IMPROPRIETY OR CONFLICT OF INTEREST CAN DAMAGE.
THE REPUTATION OF THE CITY AS WELL AS MY INDIVIDIiAL. RF.PI.iTATION. I UNDERSTAND THAT IT IS
A FUNDAM N IAL PUBLIC EXPECTATION "FHA'T PL?BLIC OFFICIALS AND PUBLIC: SERVANTS WILL NOT
OBTAIN FAVOR OR ADV.INTAGE BECAL SI. OF TTIEIR PUBLIC SERVICE. ITIS WI I H THLSL VALCES IN,
MIND THAT 1 FURTHER �GRE,E THAT I WILL NOT ENGAGE IN A 3l1SINESS RELATIONSHIP WITH THE
CITY DURING`THL TERM OP MY 1PPOCN I MI NT.
THE MAYOR'S OFFICE THANKS YOU FOR YOUR APPLICATION.
IF YOU HAVE ANY QUESTIONS, CALL 320-650-3105 OR 320-255-7201,
DATA PRACTICES ADVISORI'
Some or all of the information that you are asked to provide on this application W assified by state law as
either private or confidential. Private data is information which generally cannot be given to the public, but:
can be given to the subject of the data. Confidential data is information which generally cannot be given to
either the public or thesubject of the data.
Our purpose and intended use of this information is to determine and recommend qualified candidates for
appointment to City Boards and Commissions. You are not legally required to provide this information. If
you refuse to supply the infarmation, we may not be able to further consider your for appointment.
Protected information will be shared with administrative staff of the City of St. Cloud and the St. Cloud City
Council.