CITY OF LAKE PARK 2032 2nd Street ~ PO Box 239 Lake Park, Minnesota 56554 (218) 238-5532 ~ www.lakeparkmn.com Application for Appointment City Council Please complete and return with a letter explaining your experience in a sealed envelope to Clerk’s Office by 4:30PM May 1, 2015. 1. Full Name: __________________________________________________________________________ 2. Physical Address: ____________________________________________________________________ 3. Phone Number you can be reached at: _____________________________________________ a. Please circle the what type of number this is: HOME CELL WORK 4. Please circle the 2 departments with which you would most like to work as a liaison: Clerk’s Office Utility Department Liquor Store Police Department Senior Nutrition Fire Department 5. Tell us a little about yourself: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 6. What unique aspects will you bring to the current council? _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 7. If you are not chosen to be appointed, would you still be willing to participate on any city boards or committee? Yes No Equal Opportunity Employer