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IFFAPPLICATION FOR ADVISORY GROUPS <br /> Group Applied For: <br /> n•t <br /> Second Choice - ��V2 m 2 - CDm en-= 4)1.7 i <br /> Cry): <br /> 1�y� ��. <br /> � � coCaYY1m��� Oil <br /> Full Ni IIame (print or type): <br /> Address: I •4 rnO-'r` - <br /> � �a C . Lo�� -127-t).4. ,. mo -rSc 8g�� <br /> Years at Trus Addr t'1-YDS l�i �� I <br /> Years You Have Lived in Mounds View: <br /> Telephone: Home: //z... <br /> Work cr Other-. <br /> ' ► -ggW:, lag (, <br /> CUAL(FiCA770NS YOU WANT• �S <br /> �C HAVE THE COUNCIL CONSIDER <br /> Skills and Interests: <br /> S e e. a-f-�a.�- c <br /> • <br /> Employment, Occupatiorr cr Otter E. erien <br /> cam. <br /> I <br /> Memberships, Accomplishmentcr Ct er •- <br /> Cc,.almazdcns: <br /> I I <br /> i <br /> Pease Std your Reasons For WinTo <br /> � Serve er✓e Cn 'This Committee: I <br /> Your resacnse to aryof 'te above may <br /> be =ntinceci cn theback and , cum - i <br /> 4.41 any other materials which you wanethe C <br /> ot:rtCJ to insiderer, • <br /> f <br /> Signarc:re\ A' s f <br /> • U ^ �l'/�C� <br /> Qate�,oZ.�l� <br /> The City of Mound View ismm" ` <br /> acr- to its programs,V committed to ;e police stat ail e. <br /> Sed a facilities, and employment without persons shall have cicr. <br /> 5e, naticnaj origin, cr handier. regard to race., ��'. c:tor. <br />