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APPLICATION FOR SCOBERT PARK ADVISORY COMMITTEE <br /> Please Print <br /> NAME <br /> Last First <br /> ADDRESS PHONE <br /> Street City Zip <br /> Do you reside within the Eugene City Limits? Yes No <br /> 1. Of the below groups, which most closely fits the interest you would represent? <br /> Houseless West Blair Neighborhood Live within 1 block <br /> Local Business Social Service Provider Horticulture <br /> 2. What experience or qualifications do you have? <br /> 3. What specific contribution do you hope to make? <br /> City Council Policies: <br /> City of Eugene employees: City Employees may not serve on City of Eugene citizen committees except as <br /> specifically provided by City ordinance or as required to perform official City duties. <br /> Public Information: Information submitted on this form shall be considered public information. <br /> Signature of Applicant Date <br /> Application may be submitted in person until 5:00 p.m. on October 7, 1996 at either: <br /> Public Works Maintenance Whitetaker Public Safety Station <br /> 1820 Roosevelt Blvd. 520 Blair Blvd. <br /> Eugene, OR 97402 Eugene, OR 97402 <br /> NOTE: Applications submitted by mail should be sent to Public Works Maintenance <br /> Este forma es disponible, llama numero 687 -5220 para pedirla <br />