sou"lFtSit�� + CHAMBER OF COMMERCE

2017 Candidate Questionnaire

Candidate's Name: J:c-/ J c-f £ /Candidate for Position: �If. '7a. c.. u 1v /4auc, I - h5 1 T;at/1 :.tF;:i...._

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Home Address: City Seu7ic . WA Zip fg, /f?9 Personal E-mail: 7"L.tt/4.vfl f-c kBt/er/ 2-0H , 12� f-

Contact Information:

Employment Status: D Currently Between Jobs

Page 11 of 4

D Currently Employed � Retired Since 2::!2lf!- D Other __________ _

Company/Organization: ________________ How Long? ___ _ Position: Employment Address:

___ Zip _____ _

Please fill out (feel free t use additional space to complete your answers) and return to:

Email: Andrea@Seattl SouthsideChamber.com or Fax: (206) 575 2007

Post: Seattle Southside Chamber of Commerce

14220 Interurban Ave S Suite #134

Tukwila, WA 98168

ALL QUESTIONNAIRES MUST BE RECEIVED BY 5PM on AUGUST 9th

TO BE POSTED TO OUR

WEBSITE WWW.SEATTLESOUTHSIDECHAMBER.COM

AND SHARED WITH OUR MEMBERSHIP

We are looking forward to your participation! Thank you for your consideration.