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Office Use Only <br />Appl. by AA <br />Res <br />Date <br />MINNESOTA OPEN APPOINTMENTS ACT APPLICATION FOR SERVICE ON STATE AGENCY <br />Appointment <br />Sought: <br />Applicant <br />Name: <br />Applicant <br />Address: <br />Metropolitan Council Representative from District 3 <br />(Enter the name of the agency for which applicant seeks appointment) <br />Arlene <br />Vickers <br />(First Name) <br />(Last Name) <br />1678 Ridgewood Lane <br />Roseville, Minnesota 55113 <br />(Street) <br />(City) <br />(State) <br />(Zip) <br />Daytime 645 -3770 or <br />Phone: 645 -5666 <br />County: Ramey <br />Legislative <br />District: 63 A <br />Did the appointing authority ask you to submit this application? <br />YES ❑ <br />NO MI <br />STATISTICAL INFORMATION <br />The following information is optional and sought only for the purpose of compiling a required annual report to <br />the governor and the legislature. Put an X In each appropriate box. <br />Political Party Race /National Origin <br />Sex <br />STATEMENT OF QUALIFICATION <br />Minnesota Statutes 1 5.0597 requires that the application include "a statement that the nominee satisfies <br />any legally prescribed qualifications and any other information the nominating person feels would be helpful <br />to the appointing authority." (May include employment, community service, education.) <br />I have been a resident of Roseville for the past twenty years. The following <br />is a stmna y of the pertinent aspects of my background: <br />EDUCATION: Juris Doctor, University of Minnesota Law School <br />B.A., Political Science, University of Minnesota <br />Additional postgraduate courses in accounting and canputAr pioryLanming <br />EXPERIENCE: PractiLcci law in the following areas: contracts, corporations, business, <br />securities, real estate, estate planning, personal injury, family law,* <br />*Continued on back. <br />(May continue on back) <br />I, the undersigned, hereby state that I satisfy, to the best of my knowledge, all legally prescribed qualifica- <br />tions for the position sought. <br />(Signature of Applicant) <br />/// <br />(Date) <br />If applicant is being nominated by another person or group, signature indicates consent to nomination. <br />You will not receive an acknowledgment of this application but the appointing authority will notify you if an inter- <br />view is desired. <br />RETURN THIS COMPLETED APPLICATION TO: JOAN ANDERSON GROWE, SECRETARY OF STATE <br />Open Appointments Section <br />180 State Office Building <br />161 21 2 96480 5 PAGE-6- St. Paul, MN 55155-1299 <br />