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APPLICATION FOR MEMBERSHIP <br /> CITIZEN ADVISORY COMMITTEE (CAC) <br /> RICE 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: Date: <br /> Return form to: Rice Creek Watershed District kaxtell @ricecreek.org <br /> 4325 Pheasant Ridge Drive NE #611 Fax: (763) 398 -3088 <br /> Blaine, MN 55449 Phone: (763) 398 -3070 <br />