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CITY OF FALCONHEIGHTS <br />COMMISSION/COUNCIL APPLICATION MAR Q 6 20Q3 <br />DATE: 3 f `{ v 3 <br />NAME: ~c~~c t¢..1 \ `~-l.o~.P ~ <br />ADDRESS: L ~~(,~ ~~ d~ 5r <br />PHONE: (H) ~~l- ``(~ - Si34-6 (W) ~ lZ • G~~ - 5'! Y f <br />HOW LONG AT ABOVE ADDRESS? _ Z rya ~h~ f <br />IN WHAT CAPACITY DO YOU WISH TO SERVE? _ -J¢.;1 L,. ~o ~ ~cJ Ca,,,,~,,,, <y st ~J <br />REASON YOU WISH TO SERVE ON ABOVE: ~ 'I~t,,L ., ~ o'F o'F~ ~y.~,r;G~...,t•„ <br />t" t. ~~~ `-V 6.w taw K .t ~t O r et, K t L t Lu O /w ~ ~, ~ .t I .~C IV ~j t ~~,., ~,,~ <br />v '~ ~ t <br />~~-cric ~« . I S ls~ ~¢ I«t~...e I ~...sak I ~. lA .,.4 4 (o ~ ~, l~n. ,_~'-~,,,. <br />T~'l(„ ~10e• ~G.. '10~.. ~tn.~ ~4. ~/`~.~+.~ M ~ Ot1~ <br />PRIOR PUBLIC (OR RELATED) SERVICE: ~ (,~.,~,,,,~ S«v~? d,,~ ~t,~, P~yf .~ ~~ds <br />C.~t... / ~vr <br />~J <br />o ~~ tn: L...Q <br />~v~k c ~.d,c. w.I~,,,t., - ~c. o Ti~sQ w ~ wl G~ e <br />Gt.~ a~ C01~u.~L~.K.~~ ~ ~~ ~w:~'f' f`C.~Tt~.S~;~ w'"'~ c,,t.~tc~...kt~..:~,~~. <br />OTHER RELEVANT BACKGROUND (OR COMI~~NTS): <br />I ~ G ~~Cw wot'~ ~r <br />Y-`i 1^~4 0 ~ ~GL ~ /~O~ ~t)~~I L Zci~ <br />~ ft- P ( wo r ~C..-e <br />~; rec ~~ (~~ ~~ ~,-caw <br />~ ' '~r, ~t 5 -i Inc 5~ ~`! ~ ~~, _ <br />-D w. wt. cti ~ ~ I ~. ~ r-v <br />1 ~ Gv we rta `..n.,~ ~ ~ ~.C he,. i \ ~5 .~ q ~ I,.~o ~ w o~ <br />r`~ d r <br /> <br /> <br />~~~ <br />