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-�_ � __ _- w _- - 1 <br />APPLICATIOLV FOR ADVISORX G�OCJPS : <br />'IGroup �polied For: �'' <br />C (' oh <br />Second Choic� (i: any}: <br />ull vame (print or type): <br />Address: <br />.� �/ _ ,� <br />Years At This A c <br />res�: <br />Telsphone: Hom - <br />— - - �� I.�t� 'S�`�� - <br />m: c. ��✓�� /hPi7� <br />v,P <br />� <br />�rt /'�C- A.77' i C� <br />��� � � ��� <br />Years You Have Liv <br />. <br />Wo r:c <br />� <br />'/!J/ll i�'J'i �r� <br />s .s �r� <br />Mounds View: _ <br />vuier: <br />_ 7D�r � <br />QUALIc IC�'''IONS YOU WANT TO Hr1VE THE COUNCIL COIVSI.DER <br />^ �' 1 i ., ' <br />� ��LS ana ln teres ts • �,��Qrr� / /,S�_r;,��r.r,1 L�,� ✓?f. /`!'AO'��id► �' A,� <br />'r�4Ci�q ar �t �.� �? �'r <br />/� 4 l�- Gyit�%Ca.�cr«��r1�nf ���► r�.���iJ. l��er;�f� <br />� y�';n �. �/�-( �i,f► an �-� �;'�n ���! G�!� �� ��-i �CN%i� P,J'1' 4'�' <br />f �-Ntf1'� an� ft,C'.r"dC.'$�tri� . <br />�moloymen'° Occ at � on r Ot:Zer Ex�erienc2° ��/ � <br />G��.-,, �� o��• �/ /9Q� �'a �es���`-= O��tc� �-� �a a P c <br />o� �s� ;� /98¢ . ,�c�.r,./�� 21s ,�������f�'!�c�� /99� � �9 ,� . � v��� <br />q9� � �I^�1p� ��"�-r.d< -e�rr�hC� %� .//�irci'�r'� Gu� ��r-r�'n�f'fPJ CI�� <br />/; c r� �l �� 7�"�' ;i ,�;�I P11', �%��cr�u.��l n � i ol�i�i'/IoD N �' r D/ �: �q�i►i�r /'c ' /cY�� <br />�emoe_�nips, �j� comolis e�}�s Or Ot:�ez Quali�j`j ica �o s• � <br />/. C� � � <br />%� 1'.%q _¢/ Mf %�%4 Gll� y�(,�% �6'"[al �S C,C!' ✓�.�f'o C�c���l <br />tc� <br />• �'�+%��� -S/�srer: c,�,A�d/.t �i'/,(r' .�>auna�/' /-1tv�No.� Os��l C/f�� ,iu��r�wh (� <br />'. C;,� a� �/o`: �r `/;e�d �o/t�'�ou�se T�t�'.� �rci � -��¢.1`�'v .� c ;�{r�t • <br />��, / '� �� ����n,y <br />. %9�� C%� o �-/i�d�ne��i' ���rl/� ��i�ri�'�d�` �JfinP11' �it�rd� � bii[. - �„�'%t f r7�i.r�1�' . <br />– f�v(vn�!/`�'i�! — i7"1d. �f �'�1�/��L< p t � <br />� � � ��esf <br />?1�7�se Stac� '�our �easons cor 'Na ��o Sa�-� On T;�i.s/�- �[RIR1}' �''-2,°: <br />��IA.nL e�.� -c'C0� i n,.�c l/IJ�� ��/tr 4�7/��! r' � �`��Tll/�l �' (/; G�• �=P �?�h <br />��-�`�/S.'�/� �ht,U'c1" 4 ��i YI���`/� 7�����GL� �i1i oP1-.r'� � �%� �i <br />eq%t C� /i70/'t .f� �/�1 ��i17i�C. -O7�i.,/Y� hC e �°��t'�i+��i.0 �/iIOJP/'��,���s!- ���t�: <br />C� �e vl/'�rn{�7`'' <br />Yc"ur r?s�ons2 to anv o <br />and vou ��ay a E�ac" any <br />�- ----= �--- <br />Signatur? <br />�:e above mav be conti�usd on the bac!{ <br />th� ;natarials whic'� you wanc the Council <br />The C i ty ot Mou'nds v iew is `committed to t:�e nolic•� C.`�at a�'_ � <br />�e�sons shall 'nave equal access to its pL"�CI�3Ii1S� facilit'_es, and <br />�3:TtDlOVLR@C1t WLr:1011t L'2C�dYd t0 �3C°� C�°OG�� COIO�� S2:{, age� <br />national origin, or handicao. <br />G] <br />.lGtl <br />0 <br />