|
Dec 01 08 12: O1p Amundsen 7837885899 p• 1
<br /> UJ:":'.:,.,
<br /> IIII .... ;Ii,1_ , City of Mounds View
<br /> 2401 Highway 10
<br /> Mounds View, MN 55112
<br /> �,--. 'j'Pirtner���p, Phone 763-717-4000 Fax 763-717-4019
<br /> www.ci.mounds-view.mn.us
<br /> Application for Advisory Boards and Commissions
<br /> Board/Commission Applied for: COAJCovilci oEV E-4.OPME?U dyl'imi,.c.s/bAl (etc)
<br /> Full Name (Please print): VA -PJe AillU,JDSCA
<br /> /
<br /> Home Phone: 7(03 ~-7g(P r.5-10'(1 Work Phone: 76 3 -7e6-5&i79
<br /> Cell Phone: 642"W7",5&,'/6 Years lived in Mounds View: "' 3 0
<br /> Address: 3o 11-g AOON LE bR/UC , MDu,bs Ilii i IV A) 5571 a
<br /> Email address: A IUN b5 l) COmC/R 5 ' AJE T
<br /> Qualifications you want to have the Mayor and City Council Consider:
<br /> Skills and Interests: I I'tcWa t_ LAA.4_,:u24--, oie ,• Pviii `ffto Oc&acvt `PceioJ e .•
<br /> io.uiw a odi-k. 114, - r //iatiull.G4C_0_ -c4o.
<br /> J( rpt . ay,41 /j4 + /U - ` - duo . i/x,14 dv�z'e z� ,
<br /> -
<br /> Oo�lz v-r-t84� L ii0124,2Crfrt1 . ZIa' 1 -L4: o- . /1I4mycaarct' s 1u(Mc jiQ 4701wi11y.
<br /> Employment, Occupation or other Experience: ,has/: icy L p Ala..4df €'-4/ da4d4. ,
<br /> Ai eake, il ,fit -S>4te_ ( /'/ o �� z), d a v / (i4at)�
<br /> i irr�A.)-e-L) , Now -4y 71;10--11.C.42/rejr .
<br /> Memberships, Accomplishments or Other Qualifications: Mai t/dlcc4 t "cs;4oi i ucciat
<br /> PTAs' rtt, ride P-�/c/,6, 5 Q �ckzio hO /yrs err «{r,z;d1,./;shzc4 t,,tiie,
<br /> PTA (emi-u , .f lcvAe /) Gran /S//a e.� VUnrai ih7Jani Ud Was
<br /> ky y , i,,,,,_,”,,--//1 toy 41I!/ spa.&
<br /> .y
<br /> Please state your reason1�// for wanting to serve with this group: ,ice_ /viva .cd �-r� c.�,
<br /> 4,4 " 07411 GL�T�J `,0'CQF'af.r f t is /Ips Ga- 1 -QPP }1.P -_,,,,lift(J /6uafica�
<br /> P r 7.1,/¢A. of//ssn5 2L 4 Ili " 1-ktk ha Rh. 0 _Ati-on4,4,..`rr ,:, ‘/1,..2_,
<br /> P/J) art 4, a L we dU2,LLliriat 7 .CQ t , 1'd 7/17,-e-</-6 , e at-/�Y. ,'.4/"sur- ,
<br /> f ff'
<br /> Signature: Vp Y 4ti1 cul l Date: +'zsl�
<br /> ••nur response to any of th bove inquiries may be continued on the back of this form and you may attach any
<br /> other material that you would want the Mayor and City Council to consider.)
<br /> The City of Mounds View is committed to the policy that all persons shall have access to its programs, facilities and employment
<br /> • without regard for race, creed, color,sex, age,national origin or handicap.
<br /> cTit a,K, C you * Jc 4-+r�:-u=y-� G��(.- 0,: -. l ,1 �[� /I w JI
<br /> O-, rr
<br />
|