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2020 Board and Commission General Application <br />Page 2 of 4 <br />LCity,/ <br />Louisville <br />COLORADO • SINCE 1878 <br />CURRENTLY SERVING ON A BOARD: <br />Do you currently sit on a City Board or Commission? ©YES 0 NO <br />If Yes, please identify that board. <br />PPLAB <br />SCHEDULING CONFLICTS: <br />What times Monday through Friday are you generally unavailable to attend <br />meetings? The meeting times of each board are listed on the City's web site at <br />www.LouisvilleCO.gov; most meet in the evening, but a few have morning <br />meetings. <br />M-F 8-5 <br />DISCLOSURES: <br />Within the last ten years, have you ever been convicted of a crime or received a <br />suspended sentence, deferred sentence or deferred prosecution, or forfeited <br />bail, for any offense in criminal or military court, or do you have any criminal <br />charges currently pending against you? Exclude minor traffic violations. <br />0 YES 0 NO If yes, list for each case: (1) date of offense; (2) charge; (3) <br />jurisdiction; (4) court name and (5) disposition: <br />Within the last ten years, has your driver's license in any state ever been <br />suspended or revoked, or have you ever been denied a driver's license in any <br />state OYES 0 NO If Yes, please explain below: <br />Have you ever been involved in an incident involving child/elder abuse or <br />child/elder neglect for which a report was filed with or issued by any law <br />enforcement agency or social services agency? OYES ® NO If Yes, <br />please explain below: <br />Do ou or a company you work for or own do business with the City of Louisville? <br />OD YES ® NO If Yes, please explain below: <br />10 <br />