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<br />APPLICATION FOR MEMBERSHIP <br />CITIZEN ADVISORY COMMITTEE (CAC) <br />RICE CREEK WATERSHED DISTRICT <br /> <br />Name: <br /> <br />Address: <br /> <br />City/State/Zip: <br /> <br />County: <br /> <br />Ph#: Home: <br /> <br />Work: <br /> <br />Emaif: <br /> <br />Resident of RCWD? [ ] Yes <br /> <br />Years: <br /> <br />[ ] No <br /> <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 /> <br />Qualifications: (May include education, occupation, volunteer experiences, etc.) <br /> <br />Civic, Professional & Community Activities: (past and present) <br /> <br />Reasons for wanting to serve on this committee: <br /> <br />Other comments: <br /> <br />Signature: <br /> <br />Date: <br /> <br />AC Form 4/1/87, rev. 3/1/89, rev.1/25/08 <br />