Laserfiche WebLink
<br />ATTACHMENT B <br /> <br />ApPLICA TION FOR ApPOINTMENT TO <br /> <br />CITIZEN ADVISORY BOARDS AND COMMISSIONS <br />For Human Rights Commission March 2007 Interim Position only <br /> <br />G <br /> <br />Name of Board, Commission, or Committee Human rights Commission <br /> <br />Please print or type <br />Name <br /> <br />Mary Elizabeth Otten <br />First . <br /> <br />Middle <br /> <br />Last <br /> <br />Home Address <br /> <br />1612 Lincoln Street Eugene 97401 <br />Street <br /> <br />. City <br /> <br />Zip <br /> <br />Home. .relephone <br /> <br />Daytiine Telephone 684-4717 <br /> <br />. Do you reside within the. city limits? CJ~Yes <br /> <br />aNo <br /> <br />If yes, how long? 4 years' <br /> <br />City Council Ward ward 1 <br /> <br />Neighborhood Organization' Jefferson West Side <br /> <br />OccupationIPlace of Employment retired federal employee <br /> <br />Business Address <br />'NA <br /> <br />Fax number (if applicable) <br /> <br />.Email (if applica~le) maryotten@comcastnet <br /> <br />How did you learn of.this vacancy? <br /> <br />[J Newspaper <br /> <br />CJ Word of Mouth . <br /> <br />O~Mail <br /> <br />o Web page <br /> <br />Other source <br /> <br />NOTE: Information consisting of home addresses andphone numbersmf!Y be exemptfrom disc/osureper ORS 192.502(3). <br /> <br />OPTIONAL INFORMATION <br />The Eugene City Council sUpports diversity and seeks to appoint persons who represent the diversity of the community. By <br />providing the information below, you can help the City Counci/to know if the appointments match the diversity of the <br />community. Applicants are considered without regard to race, sex, color, national origin, age, religion, marital status; <br />medical condition, or disability. In some instances, however,. appointment to certain boards/commissions may be basedupon <br />the need toftll specific positions on the board/commission. <br /> <br />(J Male <br /> <br />[J~Female <br /> <br />(J 18 and under <br /> <br />CJ 1 9~25 <br /> <br />[J 26-35 <br /> <br />CJ 36-45 <br /> <br />[J~46-55 <br /> <br />[J 56-65 <br /> <br />[J66 + <br /> <br /> <br />Disability? . <br />blind. <br /> <br />O~ Yes <br /> <br />ONo <br /> <br />If yes, please describe I am totally <br /> <br />C:\DOCS\hrc-application;doc <br />