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10.1. SR 10-06-2014 City of Elk=' Request for Action River To Item Number Mayor and City Council 10.1 Agenda Section Meeting Date Prepared by Work Session October 6, 2014 Jessica Miller, Executive Secretary/Deputy City Clerk Item Description Reviewed by Energy City Commission Interview Tina Allard, City Clerk Reviewed by Cal Portner, City Administrator Action Requested 1. Interview TeriAnn Flatland for a vacancy on the Energy City Commission. 2. The Council could appoint,by motion,TeriAnn Flatland to the Energy City Commission as the school representative with a term to expire February 28, 2017. Background/Discussion The Energy City Commission has a vacancy for a representative from a school located in Elk River. This position has been vacant for quite some time. Ms. Flatland is employed by Independent School District#728 at Salk Middle School. Financial Impact N/A Attachments • Application • Possible Interview Questions P a w E A E U s r Template Updated 4/14 INIAfUREI APPLICATION FOR APPOINTMENT TO CITY Elk ADVISORY BOARDICOMMISSION Ters beginning in March RivTerms 431165()--.M,k-, '63.GJ i,61X]!1 Thank you for your interest in serving your community] Please indicate in order of preference on which of the following boards and commissions you are interested in serving with 1 indicating your first choice,2 your second choice,and 3 your third choice. 171 Energy City Commission ❑ Parks and Recreation Commission F-1 Heritage Preservation Commission ❑ Planning Commission ❑ Ice Arena Commission ❑ Utilities Commission All terms are three years and begin on the first day of March. See the specific board and commission description for additional information. APPLICANT INFORMATION Name: Teri Ann (T.A.) Flatland City of Residence: Elk River Occupation: Curriculum Coodinator Employer: ISD 728(Salk Middle School) Statement of Interest: Please state briefly why you are interested in serving on the board/commission for which you are submitting this application. As a member of the Elk River Area community and as an employee of ISD 728 school district I feel that I would be a good liaison between both of these great entities. Relevant Experience: Please describe your educational,professional, civic, or community participation,which may be relevant in serving on this board/commission. I currently have a Master in Education and work as the S.T.E.M. Curriculum Coordinator at Salk Middle School. This position requires me to be a liaison between ISD 728 and Northwest Suburban Integrated School District. I have coordinated multiple community involvement opportunities between the students at our school and the local community. Attendance:Are your aware of the importance of regular meeting attendance including the time commitment involved 2r,epffNo for meetings,and do you feel you have the time available to be an active participant? s Comments: Conflict of Interest is defined as the participation in any activity,recommended action,or decision from which the individual has or could have the potential to receive personal gain,whether it be direct or indirect. (See attached "Conflict of Interest" Ordinance) In accordance with this definition, do you have any legal or equitable interest in[ff�o business, however organized,which could be construed as a conflict of interest?Dyes If yes, provide details on a separate piece of paper. Teri A Flatland "` 08107!2014 pw;nee.t.4 F41-w6N MtlGa 6--SD Ida. .so�nv wr-0 ...z us Applicant Signature Date Questions may be directed to the Administration Department at 763.635.1000. application This on • • • must be filed. OFFICE USE ONLY XNew Applicant ❑ Reappointment Council Meeting Date: ❑ Appointed to: Term Expires: ❑ Not Appointed