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ADDITION_Sanville Committee ApplicationCommittee or Commission Application Name *Address * Phone *Email * Residency * Committee or Committee * Have you served on any Scandia Committee or Commission in the past?* Experience Special Interests Volunteer History Optional In accordance with M.S. 13.04 Subd. 2 we must inform you of your rights as a subject of government data. The information you give us about yourself is needed to identify you and assist in determining your suitability for the positions(s) for which you are applying. The information that we collect about you is classified as either Public or Private. Public means that it is available to anyone who asks to see it. Private means that the information is available only to the person the information is about and to the staff who must use it in the normal course of conducting City business and as otherwise provided for by law. By entering my full name, I am affixing my signature to this application and acknowledging that an investigation may be conducted for use in determining my qualifications. I hereby expressly Kathy Sanville 19246 Meadowridge Trail N ( 15 months How long have you been a resident of Scandia? Select the Committee you are applying to: Capital Investment Committee Parks and Recreation Committee Planning Commission Tourism Committee Wastewater Committee Yes No List any governmental, service organizations, or professional activities which you have been or currently are involved in: Board Secretary for 5 years; Compas (non profit organization that supports teaching artist residencies in pulbic schools) Learn to Ski Coach many years; Endurance United (non profit organization promoting healthy lifestyles and family recreation) High School Nordic Ski Coach volunteer for 5 years; White Bear Lake Area Schools Volunteer Course Setter/ Vetter for 3 years, MNOC (Minnesota Orienteering Club) Retired Chemical Engineer, Ecolab Inc List any of your special interests, activities or hobbies which you have that would apply to this committee: nordic ski coaching/ teaching/ event planning mountain bike single track riding orienteering event planning kayaking/ triathlon/ hiking/ road bike group rides Wilderness First Responder certified In what volunteer activities have you participated? What was your role? non profit board secretary sports coaching/ teaching event planning You may attach a resume. The selection process will vary according to the number of applicants and vacancies. Your application will be kept on file for one year. authorize release of any and all information which any organization, company or person may have, including information of a confidential or privileged nature. I hereby release the City and any organization, company or person furnishing information to the City, as expressly authorized above, from any liability for damage which may result from furnishing the information requested. Signature *Kathy Sanville Typing your name in the box will be considered an electronic signature