Laserfiche WebLink
APPLICATION FOR ADVISORY GROUPS <br /> OR COMMITTEES 0 <br /> • <br /> Name of Group or Committee Applying For. ?A Z <br /> Second Choice (If Any): <br /> Full Name (First,Middle,Last): D/ptlit-i ' b al If <br /> Address: e9,;9 Plear,4 hT 1)1eeu brit"� <br /> Years At This Address: 5-. <br /> Years You Have Lived In Mounds view: 3- <br /> -Telephone Number Home: 93 -60-7.--) Work or Other. <br /> . QUALIFICATIONS YOU WANT THE CITY COUNCIL TO CONSIDER <br /> Skills and Interests: • <br /> /� <br /> Employment, Occupation, or/,Other Ezperience: - / <br /> Memberships, Accomplishments, or Other Qualifications. <br /> /ri41-frri "17°,01-4166 <br /> Your Reasons For Wang To Serve On This C mime- r.( t�v <br /> Please State You AdliLl <br /> J � y,2 t„� <br /> .scco Vazid,11417Zr'el. C4)(Y-)4`j . .,-4z2,4, til-,_,.. e<:- a6 /ifo-ez,-- c,Li..,, <br /> �z ,,4 a- <br /> Ycur response to any of the above may be continued on the back, and you may attach any <br /> other materials which you want the City Council to consider. <br /> 1 ,-, <br /> 2 Date <br /> S iziature i 4, / <br /> toequal access to its <br /> the police hat all persons s.hail have ase. ;latices • <br /> The City of Mounds View is committed creed. color, sex,oro°1' mss, facilities, and employment without retard. Co race, <br /> orin, or handicap. <br />