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Golf Course Advisory Board Application <br />Page 2 of 3 <br />11 <br />i s City,, <br />Louisville <br />• ORADO • FI \C1. 1 SS2. <br />6.).1 <br />U P Ce5 <br />CizIn <br />124 c_c - EIS "Tri71 fitb <br />S <br />412,i\-Aj C <br />i CYn- - - EI <br />NOTE: You may also attach a letter, resume, statement, or other information you feel may be <br />relevant to your application. <br />CURRENTLY SERVING ON A BOARD: <br />Do you currently sit on a ty oard or Commission other than the one for which you are <br />currently applying? ❑ YES NO If Yes, please identify that board. <br />SCHEDULING CONFLICTS: <br />What times Monday through Thursday are you generally unavailable to attend meetings? (The <br />meeting time +f each •oard are available o the Ci s web to t w t,,LouisvilleCo.gov.) <br />DISCLOSURES: <br />Within the last ten years, have you ever been convicted of a crime or received a suspended <br />sentence, deferred sentence or deferred prosecution, or forfeited bail, for any offense in <br />criminal or military court, or do you have an criminal' charges currently pending against you? <br />Exclude minor traffic violations. ❑ YES NO If yes, list for each case: <br />(1) date of offense; (2) charge; (3) jurisdiction; (4) court name and (5) disposition: <br />Within the last ten years, has your driver's license in any state ever been susp or <br />revoked, or have you ever been denied a driver's license in any state? ❑ YES NO <br />If Yes, please explain below: <br />Have you ever been involved in an incident involving child/elder abuse or childfelder neglect <br />for which a report was filed with or issued by any law enforcement agency or social services <br />agency? ❑ YES )<NO If Yes, please explain below: <br />