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• <br /> • <br /> • APPLICATION FOR ADVISORY GROUPS <br /> OR COMMITTEES <br /> Name of Group or Committee Applying For: l c.,"r+ l c_ 1:-...111 xi,. _t" c.,,, ,..rn'm./ <br /> Second Choice (If Any): <br /> Full Name (First, Middle, Last): b45 b _ C0,1 <br /> Address: /gay 14,..,0f if w 0. d Dr <br /> Years At This Address: Years You Have Lived In Mounds View: <br /> Telephone Number Home: -7,5:,_A-7-7, Work or Other: 7 c,,z,_r �-7___ <br /> QUALIFICATIONS YOU WANT THE CITY COUNCIL TO CONSIDER <br /> • Skills and Interests: ` <br /> ;C AS:.` %i'' gNev I ta.t= 1tf �rovXi a X !t-Md- . Arc*-- <br /> Employment, Occupation, or Other Experience: <br /> Bu c j „I-,.r c (3 Per•►k.'.Nl t")-e.-Ci c.FtL — Put s-r g <br /> Memberships,Accomplishments, or Other `Qualifications: 9 <br /> o b cc-r PI„r.a 1r A-s Soo_;c f-FS ,,,+ar, b FYt. 4-C1-/Ntc. f) R.rA A- S Gt,,f -C4-47, s Cenvvvk. <br /> Please State Your Reasons FortW�E'anting To Serve On This Committee: <br /> p cotr-1'11:10.v-VIP 1 Mcir.1tr.. vJoiki i", 4-o iMf&Ovstr +ke �s <br /> bVSktc CI;er,p4r <br /> 0 E t-14-1.1 its w v1 A s ts'-'>yotJeL -\-L -+A-')eae-, <br /> Your 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 /> Signature — 7-L- - ->— <br /> ..._i <br /> 2,---+;11.e,X_ Date -7/^-VI/ <br /> 0 The City of Mounds View is committed to the policy that all persons shall have equal access to its <br /> programs, facilities, and employment without regard to race, creed, color, sex, ace, national <br /> origin, or handicap. <br />