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APPLICATION FOR ADVISORY GROUPS <br /> OR COMMITTEES <br /> • <br /> Name of Group or Committee Applying For. �T� <br /> Second Choice (If Any): <br /> Full Name (First,Middle,Last): Jli, <br /> Address: 6Q7q Pleagan7 li/ew <br /> Years At This Address: -S <br /> Years You Have Lived In Mounds View: .S <br /> Telephone Number Home: 9!�(�-%�D77 Work or Other. /1/if <br /> • <br /> . QUALIFICATIONS ATIONS YOU WANT THE CITY COUNCIL TO CONSIDER <br /> Skills and Interests: <br /> Employment, Occupation, or Other Experience: �/ <br /> crAo �snJ/2d /44d46174- <br /> ° <br /> =4;4 . °01'4766Memberships,Accomplishments, or Other Qualifications: <br /> g To Serve On This C mittee- d t <br /> Please State Your Reasons For rled <br /> Yaz <br /> K�ijZ Gele; ecd � 4 �'�=�- �== /f1c Cmc <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 /> Date <br /> Si�nazure 72( ,4. C- 117/ `' <br /> Theof Mounds View is committed to the policy that ail persons shall have equal <br /> e, ;l aacc ss to its <br /> City <br /> prom-ams, Facilities, and employment without re=ard to race, creed, color, <br /> origin, or handicap. <br />