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APPLICATION FOR MEMBERSHIP <br />CITIZEN ADVISORY COMMITTEE (CAC) <br />NICE CREEK WATERSHED DISTRICT <br />Name: <br />Address: <br />City /State /Zip: <br />County: Email: <br />Phone #'s: Home: Work: Cell: <br />Are you a resident of the RCWD? [ ] Yes, Years: [ ] No <br />Membership Category(ies): <br />[ ] Soil & Water Conservation District Supervisor <br />[ ] County Board Member <br />[ ] City or Town Official <br />[ ] Sportsmen's Organization Member <br />[ ] Agriculture <br />[ ] Citizen <br />[ ] Other: <br />Qualifications: (May include education, occupation, volunteer experiences, etc.) <br />Civic, Professional & Community Activities: (past and present) <br />Reasons for wanting to serve on this committee: <br />Other comments: <br />Signature: <br />Return form to: Rice Creek Watershed District <br />4325 Pheasant Ridge Drive NE #611 <br />Blaine, MN 55449 <br />Date: <br />Fax: (763) 398 -3088 <br />Phone: (763) 398 -3070 <br />