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CITY OF CENTERVILLEREQUEST <br />FOR ACTION <br />Agenda Item # Department: RequestedMeetingDate: <br />, 2024 <br />Administration <br />WS 2.1 <br />TITLE OF ISSUE: <br />Application for Appointment - <br />BACKGROUND AND SUPPLEMENTAL INFORMATION: <br />Ms. complete an application for appointment to the Committee. <br />You have been provided with a set of questions for the candidate. Please "round-robin" the questions and complete the form <br />contained in your packet. <br />COST AND SOURCE(S) OF FUNDING: <br />N/A <br />REQUESTED ACTION: <br />For ClerkÓs Use: <br />SUPPORTED DOCUMENTS ATTACHED <br />Motion By: ____________________________________ <br /> Resolution Ordinance Contract Minutes Plan Map <br />Second By: ____________________________________ <br />Aye <br />Vote Record: Nay <br />__________ <br />Application and Interview Questions <br />Other (specify) ____________ <br />__________ <br />__________ <br />_______________________________________________________________ <br />__________ <br />_______________________________________________________________ <br />__________ <br />_____ <br />_____ <br />_____ <br />_____ <br />Refer to: _________________________________ <br /> Tabled Until: ______________________________ <br />Consent <br /> Other: ___________________________________ <br /> Regular <br /> <br />