Application for the position Public Member

Part I: Position Sought

Agency Name: Board of Occupational Therapy Practice
Position: Public Member

Part II: Applicant Information

Name: Kim Pettman
Mailing Address: 315 Division St. #107 Sauk Rapids 56379
County: Benton
Mn House District: 13B
US House District: 6
Recommended by the Appointing Authority: False

Part III: Appending Documentation

Cover Letter and Resume

Type File Type
Cover Letter application/vnd.openxmlformats-officedocument.wordprocessingml.document
Resume application/vnd.openxmlformats-officedocument.wordprocessingml.document

Additional Documents (.doc, .docx, .pdf, .txt)

Type File Name
Curriculum Vitae pettiman-kim-supplemental.pdf

Part IV: Optional Statistical Information

Gender: Female
Disability: Yes
Age: 52
Political Affiliation: No Answer
Ethnicity: White or Caucasian
Hispanic, Latino or Spanish origin: No

Part V: Signature

Signature: Kim A. Pettman
Date: 7/24/2017 11:36:15 PM