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APPLICATIOL� FOR ADVISORY GRO[7PS : <br />�Group Applied For: <br />I Secorcd Cho ice ( if any ) z <br />IFull Name (print or type): <br />ress: <br />Years At This Addr�ss : <br />Telephane: <br />me: <br />� <br />. <br />ears You Have Lived In Mounds,View: _ <br />wark or ���r �12-C� <br />QUALIFIC�TIONS YOU wANT TO EiAVE THE COUNCIL CO[VSIDER <br />5�ills an� Interests: <br />��%1�/1��, ��;�v1M%VVI�j CD�/VN41 `�tGE'1 � N�� ; �G�S �CO ��'�C� r <br />/�.11..-1_. n � . . � n r-, � /' �/✓ D_ \ �. � .,� . n ,. . . . �r/� / m � e _ . . ✓ . �. . �^ i ` <br />E..�nplo�rment, Occupation or IOther Experien�e: r <br />�:u,��G� i����� ���c� ���� ��IS�- �20���; <br />N�;�1�� I�I�u�i - lvW���� -� ��� �S � <br />��lemberships, Accomplishments Or O�hez QualiEications: <br />Mc�n�i� ���� <br />��� � ���� � �� �� � <br />� <br />Please Stat� Your Reasons For Wanting To SerJe On This Commit��e: <br />��� � I�i���lb� lJ1' Nl��� ���;i,c:C� � S� 1��1 � <br />�� {� � �;��,� � G�- . <br />� <br />Your res�onse to any ot the above may be continued c�n the bac:{ <br />and you ay atta �Qv other materials which you want the Council <br />to cons i.de ._ �% 1� <br />S igna ture Ca te ,� <br />The C i t_� o= M unds � iew is commi tted to the po1 ict� that ali <br />persons s�al have equal acc�ss to its programs, facilities, and <br />emplojrment without regard to race, creed, color, sex, age, <br />national o�igin, or handicap. <br />