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APPLICATION FOR ADVISORY GROUPS <br /> OR COMMITTEES <br /> Name of Group or Committee Applying For: <br /> Second Choice (If Any): <br /> Full Name (First, Middle, Last): -live, lg j <br /> Address: way tG.•01 (wt,0 Da: <br /> Years At This Address: z_o Years You Have Lived In Mounds View: 7 <br /> Telephone Number Home: -754,_,(4.7-7( Work or Other: 7 r <br /> QUALIFICATIONS YOU WANT THE CITY COUNCIL TO CONSIDER <br /> Skills and Interests: <br /> NS�v '� �Y1i Gr 1e+ i2%X:r+=i2 A-.J. . �vArc <br /> Employment, Occupation, or Other Experience: <br /> Bu r <br /> (3 �c.%N <br /> 1 �r_ s irr+ � art. Plasm— Sa-o1G. <br /> M�eemberships, Accomplishments, or Other Qualifications: <br /> r it <br /> tlo6cFR- ortls /rsSoc._s.APFS ri► 10 bFrt. -4-CkA-i,R... DC Kr.,/1- Si feta -5hl; Ce-men. <br /> Please State Your Reasons For Wanting To Serve On This Committee: <br /> ' cor-A-ralov-430'i wNriv. ' pt,. v-itukic..•1 4-O irokrdflv5= 4-ke bvski cline <br /> D E t_14-40 Pcr w lel1 p S 74ipt4 4-Lia -mak Mr, <br /> Your response to any of the above may be continued on the back, and you may attach any <br /> Iother materials which you want the City Council to consider. <br /> Signature Date 74I/9-7 <br /> 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, age, national <br /> origin, or handicap. <br />