Submit Date: Dec 31, 2018

First Name Middle Initial Last Name

Home Address Suite or Apt

City State Postal Code

Email Address

Alternate Email Address

Primary Phone Alternate Phone

Employer Job Title Occupation

Washington County, OR Boards & Commissions

Application Form

Profile

Are you employed in Washington County?

Yes No

If you live in Washington County, in what district do you reside in? *

District 4

District look-up here

What days and times are you available to meet?

Mondays to Thursdays at 9am.

Please list the Washington County Boards that you are currently serving on, or havepreviously served on (include the dates of your term).

Interests & Experiences

K S Venkatraman

Hillsboro OR 97123

NVIDIA CorporationDirector of GPU and AIcomputing

K S Venkatraman Page 1 of 4

If you selected multiple Boards, which is your preferredchoice?

Which Boards would you like to apply for?

Budget Committee: Submitted Homeless Plan Advisory Committee (HPAC): Submitted Housing Advisory Committee (HAC): Submitted Housing Authority Board of Directors: Submitted Park and Recreation Advisory Board: Submitted

How did you hear about the Board/s you are applying for? *

Social Media

Why are you interested in serving on the Board/s you are applying for?

I am excited to learn about the Washington county's commitment towards ending homelessness, meetingthe housing needs of low-income families and particularly recommending programs with a public/privatepartnership to achieve goals with measurable and positive outcomes. I grew up in an academic family inIndia and came to the US in 1995 to pursue a graduate degree in Electrical Engineering and lateraccepted a position with Intel Corporation in 1997 at Washington County. Over the past few years, I havebeen touched by the income inequality and consequent homelessness that is affecting our communitiesand would like to be a part of the solution, bringing a technology perspective.

Are you interested in other volunteer opportunities?

Yes No

If you are interested in other opportunities, may we contact you?

Yes No

What education, work experience, volunteer experience or life experience do you bring?

Masters degree in Electrical and Computer Engineering. 21 years of work experience at Intel and NVIDIACorporation, focusing on artificial intelligence and jobs of the future. Advisory board member: OregonWorkforce Talent Development. Amateur Radio license holder and volunteer.

Describe your understanding of the concerns and issues facing the Board/s you wish toserve on.

Over the past few years, I have felt the levels of homelessness rise in my community and places I visitfrequently. Reading through the annual homelessness assessment reports, I would like to get involvedwith planning towards finding the right programs, advocating for funding and tracking measurableoutcomes towards ending homelessness starting with our county.

List any potential conflict of interest between your public and private service that mightresult from your appointment to a Board/s you are applying for.

None that I can think of.

HPAC or a housing related board

K S Venkatraman Page 2 of 4

Upload a Resume

Full name of Reference #1

Phone number of Reference #1

Email of Reference #1

Full name of Reference #2

Phone number of Reference #2

Email of Reference #2

References

Acknowledgment

ksv_resume.pdf

Kalpana Kothapally

Terence Tharp

K S Venkatraman Page 3 of 4

Please Agree with the Following Statement

By submitting this form, I am affirming that all the information is true to the best of myknowledge and that I understand that any misstatement of fact or misrepresentation ofcredential may result in this application being disqualified from further consideration or,subsequent to my appointment to a board/committee/commission, may result in dismissal.Also, information I provide on this application may become part of the public record.

I Agree

K S Venkatraman Page 4 of 4

K S Venkatraman

Hillsboro, OR 97123 USA

Summary:

● Experienced organization leader with strong technical leadership, vision and communication skills. ● Proven ability to influence and set direction across organizations to deliver successful outcomes.

Experience: Director of GPU and AI Computing, NVIDIA Corporation:

● 2015 to present: Responsible for architecture and product development for GPU computing segments ranging from HPC and datacenter to automotive and embedded businesses. Areas of focus include Deep Learning training and inference, competitive analysis, product architecture definition and feature implementation. Managing a diverse and global organization of teams responsible for:

○ Deep Learning Inference Architecture analysis. ○ GPU computing product performance, efficiency projections and detailed competitive analysis. ○ Architecture Analysis tools and infrastructure. ○ GPU computing feature exploration and execution against product milestones. ○ Deep Learning Performance Modeling and architectural tradeoff analysis.

● 2008 to 2014: Senior Architecture Manager for a revolutionary ARMv8 based SoC architecture: Tegra K1-64/Denver.

○ Chosen for the Google Nexus 9 tablet in 2014, with launch of Android 64b ‘Lollipop’ v5.0 ○ Managed teams of engineers and architects for:

■ Pre-silicon (simulators, RTL, emulation) and post-silicon performance, power for SoCs. ■ Development and verification of high fidelity C++ performance and functional simulators. ■ Competitive and user-experience analysis for existing and future Automotive SoC products.

● 2006 to 2008: Principal Architect, Fermi, NVIDIA’s first DX11 GPU product. ○ Developed a performance simulator and architecture for balanced SM work scheduling. ○ Led a team of engineers to analyze performance efficiency of Geometry and Tessellation shaders.

Advisory board member, Oregon Workforce and Talent Development:

● September 2018 to present: Advises the Governor on workforce matters, including developing a strategic plan for Oregon's Workforce Development System.

Senior Architect, Stexar Corporation (start-up, Beaverton, OR): 02/2005 to 08/2006

● SoC architect for a product targeting the HDTV/set-top box consumer electronics market. ● Architecture development and performance analysis for video processing and transcoding workloads.

○ Developed micro-architecture, performance models. ○ Guided ASIC/RTL development and organizational growth to achieve milestones.

Senior Staff Engineer, Intel Corporation (Hillsboro, OR): 07/1997 to 02/2005

● Led a cross-organizational post-silicon performance and competitive analysis team. ● Architect for Hyper-Threading technology on the Nehalem family of CPUs. ● Pentium-4 memory system architecture definition, RTL development, microarchitecture validation and

post-silicon functional bringup. ○ Worked on Willamette, Northwood and the Prescott family of Pentium-4 processors.

Hardware Engineer, Hewlett-Packard (Varanasi, India): 03/1994 to 08/1995

● Responsible for support, maintenance, sales and marketing for PCs and Unix systems. Education:

● MS in Electrical Engineering: Villanova University, PA. USA. 1997 ○ Specialization in Computer Architecture and Hardware design. GPA: 3.8/4.0

● BS in Electronics and Communication Engineering: Birla Institute of Technology, India. 1994 Patents and publications:

● “Denver: NVIDIA’s First 64-bit ARM Processor”, IEEE Micro, March 2015 ● “NVIDIA’s Denver Processor” Hotchips 26, 2014 ● "Performance Analysis and Validation of the Intel® Pentium® 4 Processor on 90nm Technology." Intel

Technology Journal, February 2004. ● "The Microarchitecture of the Intel® Pentium® 4 Processor on 90nm Technology." Intel Technology Journal,

February 2004. ● List of patents awarded

Submit Date: Nov 08, 2018

First Name Middle Initial Last Name

Home Address Suite or Apt

City State Postal Code

Email Address

Alternate Email Address

Primary Phone Alternate Phone

Employer Job Title Occupation

Washington County, OR Boards & Commissions

Application Form

Profile

Are you employed in Washington County?

Yes No

If you live in Washington County, in what district do you reside in? *

District 3

District look-up here

What days and times are you available to meet?

Any weeknight

Please list the Washington County Boards that you are currently serving on, or havepreviously served on (include the dates of your term).

Interests & Experiences

Which Boards would you like to apply for?

Budget Committee: Submitted Developmental Disabilities Council: Submitted Planning Commission: Submitted

James O Knowlton

Tigard OR 97224

Standard Insurance Test Automation Engineer Software Testing

James O Knowlton Page 1 of 4

If you selected multiple Boards, which is your preferredchoice?

Upload a Resume

Full name of Reference #1

Phone number of Reference #1

Email of Reference #1

Full name of Reference #2

How did you hear about the Board/s you are applying for? *

County Website

Why are you interested in serving on the Board/s you are applying for?

I have an autistic daughter, and would like to participate in developing policies to help children like mydaughter.

Are you interested in other volunteer opportunities?

Yes No

If you are interested in other opportunities, may we contact you?

Yes No

What education, work experience, volunteer experience or life experience do you bring?

MBA from University of Portland, Technology industry background (over 20 years experience), I have adaughter with developmental disabilities (autism).

Describe your understanding of the concerns and issues facing the Board/s you wish toserve on.

I have an open mind to learning about the pertinent issues, and working with others to build goodsolutions.

List any potential conflict of interest between your public and private service that mightresult from your appointment to a Board/s you are applying for.

None that I am aware of.

References

Developmental Disabilities Council

JimKnowltonProfile.pdf

Karin Hammer

Brent Burnett

James O Knowlton Page 2 of 4

Phone number of Reference #2

Email of Reference #2

Question applies to Planning Commission

Please Agree with the Following Statement

As an appointed member of a Washington County board or commission, I am aware that Iam considered a public official and subject to Oregon Ethics law limitations on acceptanceof gifts, food/drink, travel, and entertainment worth more than $50 per calendar year fromany source with an administrative or policy interest in your board or commission. If I amappointed to the Planning Commission, I will also be required to complete an annual formwith the Oregon Ethics Commission during the term of service. Please refer to the OregonEthics Commission website for more information about ethics requirements for publicofficials: http://cms.oregon.gov/ogec/pages/index.aspx.

I Agree

Acknowledgment

James O Knowlton Page 3 of 4

Please Agree with the Following Statement

By submitting this form, I am affirming that all the information is true to the best of myknowledge and that I understand that any misstatement of fact or misrepresentation ofcredential may result in this application being disqualified from further consideration or,subsequent to my appointment to a board/committee/commission, may result in dismissal.Also, information I provide on this application may become part of the public record.

I Agree

James O Knowlton Page 4 of 4

Page 1

Jim KnowltonSoftware Test Manager

Summary

Seasoned software professional experienced in executing and leading software testing efforts. Especially

experienced in test automation, mobile applications (both Android and iOS) and agile development.

Specialties:

- Mobile applications (both Android and iOS)

- eCommerce and mobile payments

- Test automation

- Dynamic languages (Python, Ruby, Groovy)

- Project/team leadership

- Agile development (certified ScrumMaster)

ExperienceTest Manager at The StandardMay 2017 - Present

QA Architect at NAVEX GlobalJune 2015 - May 2017 (2 years)

- Oversee quality assurance processes including defining standards, methodologies, procedures and metrics

used across NAVEX Global's engineering organization

- Research, propose and guide the implementation of testing tools and frameworks for use in automation,

performance, integration, browser and security testing

- Drive test effectiveness and efficiency throughout the engineering team

- Collaborate with engineering teams and product managers to implement best practices to build testability in

to the product throughout the software development lifecycle (SDLC)

- Lead and mentor QA team members

- Investigate, analyze and make recommendations to management regarding technology improvements,

upgrades and modifications regarding the application development process

Quality Team Lead at ZoomCareFebruary 2015 - May 2015 (4 months)

Led QA efforts,for Zoomcare's product suite.

MTS 1, Sr QA Engineer at eBay Inc

Page 2

February 2013 - February 2015 (2 years 1 month)

- Lead testing efforts for eBay core app for Android, iPhone and iPad

QA Lead, PayPal for Android at eBay IncJuly 2012 - February 2013 (8 months)

Led testing efforts on PayPal for Android, testing one of the most-downloaded apps on the Android market,

on many Android versions and on many different device types.

Software Engineer / Team Lead at McAfeeJune 2008 - July 2012 (4 years 2 months)

Developer on McAfee's Enterprise Mobility Management (EMM) platform, which provides security to

mobile devices such as smartphones and tablets. Also act as the Development Team Lead.

QA Engineer at ADP2006 - 2008 (3 years)

QA Engineer2004 - 2006 (3 years)

QA Engineer2005 - 2005 (1 year)

QA Engineer at Symantec2000 - 2004 (5 years)

Technical Writer / Support Engineer at NovellJuly 1995 - February 2000 (4 years 8 months)

System Administrator at BBVA Compass1994 - 1995 (2 years)

QA Engineer/Beta Coordinator at Novell1993 - 1994 (2 years)

Technical Support Engineer1991 - 1993 (3 years)

Information Management Specialist at United States Air Force1987 - 1991 (5 years)

EducationUniversity of PortlandMBA, Operations and Technology Management, 2009 - 2012

Page 3

Activities and Societies: Travelled to Beijing and Shanghai, China to explore the business environment and meet with local companies.University of PhoenixBA, Management, 1992 - 1995

Page 4

Jim KnowltonSoftware Test Manager

Contact Jim on LinkedIn

Submit Date: Apr 19, 2018

First Name Middle Initial Last Name

Home Address Suite or Apt

City State Postal Code

Email Address

Alternate Email Address

Primary Phone Alternate Phone

Employer Job Title Occupation

Washington County, OR Boards & Commissions

Application Form

Profile

Are you employed in Washington County

Yes No

If you live in Washington County, in what district do you reside in? *

District 2

District look-up here

What days and times are you available to meet?

See application on file

Please list the Washington County Boards that you are currently serving on, or havepreviously served on (include the dates of your term).

Sheriff's ESPD CURRENT - For about 10 years Solid Waste board 2015 - 2017

Bob Zahrowski

Portland OR 97229

Home:

RetiredUniversity professor /Businessconsultant

Bob Zahrowski Page 1 of 4

If you selected multiple Boards, which is your preferredchoice?

Interests & Experiences

Which Boards would you like to apply for?

Enhanced Sheriff Patrol District Budget Committee: Submitted Budget Committee: Submitted

How did you hear about the Board/s you are applying for? *

County website Friend

Why are you interested in serving on the Board/s you are applying for?

See application on file

Are you interested in other volunteer opportunities?

Yes No

If you are interested in other opportunities, may we contact you?

Yes No

What education, work experience, volunteer experience or life experience do you bring?

Rotary Foundation ,Aloha/Sunset club, ASQ bosrd member, IIBA BOARD MEMBER, IIBA WesternRegional Director.

Describe your understanding of the concerns and issues facing the Board/s you wish toserve on.

See application on file

List any potential conflict of interest between your public and private service that mightresult from your appointment to a Board/s you are applying for.

See application on file

Bob Zahrowski Page 2 of 4

Upload a Resume

Full name of Reference #1

Phone number of Reference #1

Email of Reference #1

Full name of Reference #2

Phone number of Reference #2

Email of Reference #2

References

RMZ_Updated_Retired_2018.doc

Bob Zahrowski Page 3 of 4

Acknowledgment

Please Agree with the Following Statement

By submitting this form, I am affirming that all the information is true to the best of myknowledge and that I understand that any misstatement of fact or misrepresentation ofcredential may result in this application being disqualified from further consideration or,subsequent to my appointment to a board/committee/commission, may result in dismissal.Also, information I provide on this application may become part of the public record.

I Agree

Bob Zahrowski Page 4 of 4

Robert M. Zahrowski ( Retired MAY 2015 )

Academic History Ed. D., Vocational Education, Minor: Business, Oregon State University, ABD (All But Dissertation) (1980) M. Ed., Vocational Education, Minor: Business, Oregon State University (1980) B.S., Education Southern Illinois University, Carbondale, Illinois (1975) Professional Licenses and Certificates Community College Life Teaching Credentials – State of California, Subjects: Photography and another in Printing & Graphic Arts.

Academic Experience

2004-2015 Adjunct Professor, Management Technology, Oregon Institute of Technology 2008-2010 Adjunct Professor, Marylhurst University (Graduate level Strategy) 2003-2006 Adjunct Professor, Management, Portland State University 2007-09 Adjunct Professor, Management, Linfield College

2006-07 Adjunct Professor Management, University of Phoenix 2005 Adjunct Professor, DeVry – Portland Campus

1993-97 Assistant Professor, Management, Portland State University (full-time) 1991-93 Adjunct Professor, Management, Portland State University (part-time)

Courses Taught Undergraduate: Business Strategy, Business Presentations, Business Law, Working in Teams, Speech, Organizational Development, Operations Management, Organizational Behavior, Graduate: Business Strategy, Organizational Development, Quality and Organizational Behavior Professional Experience

Consulting:

2001-2015 R. M. Zahrowski & Associates (Owner) 1997-01 MetaPower, LLC. (Full-time) Executive Consultant (Business Strategy and Process

Improvement) 1987-91 Solid Gold Management Consulting (Owner) Note: Have lead planning sessions and problem solving sessions for Region 10 – ECTC filling in for Dr.

Johnnie Cain - Locations in Idaho and Oregon Scholarly Activities

The Executive Guide to Strategic Planning, contributed to the methodology of 3 books (1987) Contributed to the methodology model from Pacific Learning Systems

Other Academic Duties Developed new courses, PSU in Quality and Leadership at the graduate level Rewrote a course for DeVry, to update the curriculum from case studies to simulations

RESUME

Board and Committee Memberships

Washington County Sheriffs ESPD Advisory Committee (Currently) –Committee Chair 2010 Washington County Solid Waste - Board Member – Appointed 2 years as a member by Washington County Commissioners. Youth Contact – Hillsboro – Board Member 3 years IIBA - International Institute of Business Analysts President of Portland Chapter 2 years (Board member Past-president) Membership increased from 9 to over 100 in one year. IIBA Western America’s Regional Director (2 years ) Rotary International - 18 years Membership Administrative Assistant Governor, Rotary District 5100 2 years - Coordination of other leaders – Asst.DG’s. Facilitation and training coordination of the district’s Presidents and club officers. Assistant Governor, Rotary District 5100 1 year – Providing leadership the club presidents of approx. 23 Rotary clubs within District 5100. Aloha Sunset Rotary Club, (President 1995), Club Secretary, Foundation President and other officer positions. Member, American Society for Quality (ASQ) and Board Member 5 years – Organized other organizations to be partners with ASQ in Portland, Engineering EEE Association, Project Managers Association, and HR Professionals in Portland, OR.

Portland Chamber of Commerce – Board Member Small Business Board – Establishing Educational Programs for Businesses Members. Other Activities

3 years - Taught leadership to approx 500 incoming Presidents of Rotary Clubs, at the Regional PETS Training in Seattle, WA.per year. PETS is the President Elect Training Series 9 years - Judge for DECA State Competition on Oregon and one year International Judge 6 years (two terms) Elected Local School Committee, Beaverton School District Board member of about 5 other organizations from 1990-2005 Special strategic projects for two organizations, Free Market Institute & World Affairs Council.

Community Activities – Volunteer

Washington County Jail – (Currently)

Inmate Instructor – Women & Men's Employment classes Women & Men's Parenting classes

Submit Date: Apr 13, 2018

First Name Middle Initial Last Name

Home Address Suite or Apt

City State Postal Code

Email Address

Alternate Email Address

Primary Phone Alternate Phone

Employer Job Title Occupation

Washington County, OR Boards & Commissions

Application Form

Profile

Are you employed in Washington County

Yes No

If you live in Washington County, in what district do you reside in? *

District 2

District look-up here

What days and times are you available to meet?

See application on file

Please list the Washington County Boards that you are currently serving on, or havepreviously served on (include the dates of your term).

Civil Service Commission

John Junkin

Portland OR 97225

Home:

Retired Attorney

John Junkin Page 1 of 4

If you selected multiple Boards, which is your preferredchoice?

Interests & Experiences

Which Boards would you like to apply for?

Budget Committee: Submitted Board of Property Tax Appeals: Submitted Housing Authority Board of Directors: Submitted Planning Commission: Submitted

How did you hear about the Board/s you are applying for? *

County website

Why are you interested in serving on the Board/s you are applying for?

long-time resident; appreicate county govt.; to work with govt and assist it

Are you interested in other volunteer opportunities?

Yes No

If you are interested in other opportunities, may we contact you?

Yes No

What education, work experience, volunteer experience or life experience do you bring?

See application on file

Describe your understanding of the concerns and issues facing the Board/s you wish toserve on.

See application on file

List any potential conflict of interest between your public and private service that mightresult from your appointment to a Board/s you are applying for.

See application on file

Budget

John Junkin Page 2 of 4

Upload a Resume

Full name of Reference #1

Phone number of Reference #1

Email of Reference #1

Full name of Reference #2

Phone number of Reference #2

Email of Reference #2

References

Alan Rappleyea

Bob Davis

John Junkin Page 3 of 4

Question applies to Planning Commission

Please Agree with the Following Statement

As an appointed member of a Washington County board or commission, I am aware that Iam considered a public official and subject to Oregon Ethics law limitations on acceptanceof gifts, food/drink, travel, and entertainment worth more than $50 per calendar year fromany source with an administrative or policy interest in your board or commission. If I amappointed to the Planning Commission, I will also be required to complete an annual formwith the Oregon Ethics Commission during the term of service. Please refer to the OregonEthics Commission website for more information about ethics requirements for publicofficials: http://cms.oregon.gov/ogec/pages/index.aspx.

I Agree

Acknowledgment

Please Agree with the Following Statement

By submitting this form, I am affirming that all the information is true to the best of myknowledge and that I understand that any misstatement of fact or misrepresentation ofcredential may result in this application being disqualified from further consideration or,subsequent to my appointment to a board/committee/commission, may result in dismissal.Also, information I provide on this application may become part of the public record.

I Agree

John Junkin Page 4 of 4

Submit Date: Apr 11, 2018

First Name Middle Initial Last Name

Home Address Suite or Apt

City State Postal Code

Email Address

Alternate Email Address

Primary Phone Alternate Phone

Employer Job Title Occupation

Washington County, OR Boards & Commissions

Application Form

Profile

Are you employed in Washington County

Yes No

If you live in Washington County, in what district do you reside in? *

District 4

District look-up here

What days and times are you available to meet?

Evenings

Please list the Washington County Boards that you are currently serving on, or havepreviously served on (include the dates of your term).

Public Health Advisory Council from March 2015-May 2016

Sebastian Lawler

Forest Grove OR 97116

Home:

Sebastian Lawler Page 1 of 4

If you selected multiple Boards, which is your preferredchoice?

Upload a Resume

Interests & Experiences

Which Boards would you like to apply for?

Budget Committee: Submitted Public Health Advisory Council: Submitted

How did you hear about the Board/s you are applying for? *

County website

Why are you interested in serving on the Board/s you are applying for?

See application on file

Are you interested in other volunteer opportunities?

Yes No

If you are interested in other opportunities, may we contact you?

Yes No

What education, work experience, volunteer experience or life experience do you bring?

See application on file

Describe your understanding of the concerns and issues facing the Board/s you wish toserve on.

See application on file

List any potential conflict of interest between your public and private service that mightresult from your appointment to a Board/s you are applying for.

See application on file

Sebastian Lawler Page 2 of 4

Full name of Reference #1

Phone number of Reference #1

Email of Reference #1

Full name of Reference #2

Phone number of Reference #2

Email of Reference #2

References

Acknowledgment

Sebastian Lawler Page 3 of 4

Please Agree with the Following Statement

By submitting this form, I am affirming that all the information is true to the best of myknowledge and that I understand that any misstatement of fact or misrepresentation ofcredential may result in this application being disqualified from further consideration or,subsequent to my appointment to a board/committee/commission, may result in dismissal.Also, information I provide on this application may become part of the public record.

I Agree

Sebastian Lawler Page 4 of 4

Submit Date: Apr 19, 2018

First Name Middle Initial Last Name

Home Address Suite or Apt

City State Postal Code

Email Address

Alternate Email Address

Primary Phone Alternate Phone

Employer Job Title Occupation

Washington County, OR Boards & Commissions

Application Form

Profile

Are you employed in Washington County?

Yes No

If you live in Washington County, in what district do you reside in? *

District 2

District look-up here

What days and times are you available to meet?

most any

Please list the Washington County Boards that you are currently serving on, or havepreviously served on (include the dates of your term).

development disability

Interests & Experiences

Shaun Savage

Beaverton OR 97006

Home:

Shaun Savage Page 1 of 3

If you selected multiple Boards, which is your preferredchoice?

Upload a Resume

Full name of Reference #1

Which Boards would you like to apply for?

Aging and Veteran Services Advisory Council: Submitted Budget Committee: Submitted Developmental Disabilities Council: Submitted Housing Advisory Committee (HAC): Submitted Public Safety Coordinating Council: Submitted

Question applies to Aging and Veteran Services Advisory Council

An additional short Supplementary Application is needed for this Board. Someone will contactyou about this soon. If you have any questions, please call (503) 846-3081.

How did you hear about the Board/s you are applying for? *

County website

Why are you interested in serving on the Board/s you are applying for?

See application on file

Are you interested in other volunteer opportunities?

Yes No

If you are interested in other opportunities, may we contact you?

Yes No

What education, work experience, volunteer experience or life experience do you bring?

data analysis

Describe your understanding of the concerns and issues facing the Board/s you wish toserve on.

judiciary knows about disability

List any potential conflict of interest between your public and private service that mightresult from your appointment to a Board/s you are applying for.

none

References

Shaun Savage Page 2 of 3

Phone number of Reference #1

Email of Reference #1

Full name of Reference #2

Phone number of Reference #2

Email of Reference #2

Acknowledgment

Please Agree with the Following Statement

By submitting this form, I am affirming that all the information is true to the best of myknowledge and that I understand that any misstatement of fact or misrepresentation ofcredential may result in this application being disqualified from further consideration or,subsequent to my appointment to a board/committee/commission, may result in dismissal.Also, information I provide on this application may become part of the public record.

I Agree

Shaun Savage Page 3 of 3