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APPLICATION FOR ADVISORY GROUPS _ <br />Group Applied For: <br />� CA.ei ps�-r � c <br />Second Choice (i� any): <br />Full Name (print or type): <br />����v E , � ,�- �� �s <br />� <br />0 <br />Address: ' <br />�� a 9 �i+-,�� �'ouoe.r 7>2i ci � <br />Years At This Address: Years You Have Lived In Mounds View: � <br />� v2-s � ��CS, <br />Telephone: 'Home: Work or /O�ther: <br />7�5�- �f 7 g� �LC frie,� o <br />QUALIFICATi01VS YOU WANT TO HAVE THE COUNCTL CO[JSIDER <br />Skills and Interestse <br />!Employment, Occupation or Other Experience: <br />/C � ,� J, � � ��cJ � �G �= s � O cc�,(/v .E � D/JGe .sk Q .< � ��� L ���R r� c✓ /�2c � /J.�a.u/� � .1.4-.... i.v6-2 <br />�.�-�..� KvJ�6c.� t% r�r-.cs2 � Co.u��Q�.�,a-� �9-'��Q. <br />Memberships, Accomplishments Or Other Quali�ications: <br />V ,_� �i o.vs G�.u9 <br />Please State Your Reasons Eor Wanting To Serve On This Committee: <br />z W � c. � n � �2v v r[� � M y c.Cf � c> it i EnrCGr T'u 7'-� L�. o;w c� -Y i � 1�o v�= L o,O,cirN l~ <br />,!� ui-1�o i2� (-s7 �4 S .4 C:�,�,,...r, ss.��.� .3 y �SS i57�'iiyCr iH ES/'�-iSL. iS/�fiNG. .l.%cCJ �4S/vc-'Tci <br />11+J O t.� /��-.� n�/� E�y �,�o `/ '�'`�.vY� i= 0 2 7'/1,= � r� v I_- �Occ.c. a S � t Gc:� � <br />Xouz response to any of the above may be continued on the back <br />and you may attach any other materials which you want the Council <br />to consider. � <br />Signature <br />Da t e ��� � � �{ <br />The City of Mounds View is committed to the polic� that all <br />persons shall have equal access to its programs, facilities, and <br />employment without regazd to race, creed, color, sex, age, <br />national origin, or handicape <br />