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CITY OF MOUNDS VIEW <br /> 2401 fIQHWAY 10 <br /> MOUNDS VIEW,M}155113 <br /> 612-7174000 <br /> APPLICATION FOR ADVISORY GROUPS <br /> Group Applied For, Sh.e'P./ a,S,Q�*.s'iY,e,)f <br /> C}6,Aligrec <br /> Second Choice(if any): <br /> Full Name(print or type): <br /> ES L - Soh/,,;df <br /> Home Phone: Work or Ocher: <br /> 4/(2-- 7 - 6s/- '779-s�/9 <br /> Address: <br /> Years at this address: <br /> 9f <br /> Yeats you have lived is Mounds View <br /> QCTALIPTCATIONS YOU WANT TO SAVE TEE COUNCIL CONSIDER <br /> Skills at:d Inrernsts: • <br /> 4777 Ci✓i Ie7y/reit cobr 7iai /411/QD7" ,Z'/ye pvicsfeW <br /> fir Erb eX-Ater /o✓d teer'/y C r/el exihr7i4 sal,;-;4 ,a) <br /> Employment,Occupation,or Older Erpt:ieacC <br /> T hew <9.20404.enee w ill p424414,ky/ric: , c oos 7f-;C J -,,dt siyn/sink r4i c/ And <br /> A,►•r eafeenit e.,".06 ypd .4s hie. AStYS , iv/NovaF plrr� _ Z have COxe-P#w . <br /> m �nteS 0c ;. -l))e ' C0trisc� C✓�i/s 6a•»mP•v1tr. <br /> Metaberships,Aceomplisbmemts.or Other Qualifications: tre4r. -,t'&xi /904.24: Safi. <br /> CZ-Alm Curreei744/ -mae /i-unite+- ccib Scorlt BMcle F 4,11 ad.. k)% .t1*e k, - <br /> o F ay Sto js 42ty 361. r/Ake 4ee„ Acirvc b. ,91V` tri A $,,14 Speritt <br /> kr re. wed s f v+ at 64 leo ei/ /$1ezklA .t•4 C,4 /Scup( . <br /> Please state your reason for wanting to verve on this committees 1 <br /> �tt' in, #S 'ec /'7 , N/ G'n 1if Cbl7M/lir 11- Cf 1ceel✓2'?/ ,esicki�ii <br /> rd o his kiJOK/ht ,a-r.! e Ewer c r 404 e ,.s res &/71.01474 <br /> w� r /WI b Sheds, 4sse mtent And oMtit )db/c: wilts / ia11vn • <br /> Your response to any of the above inquires may be continued on the back and you may attach any <br /> other material which you want the City Council to consider. <br /> S'gnaws= _.. _ • Daze: //ls/96 <br /> The City OW. View is committed to rite policy that all Femme.lull leave amass to les programs, <br /> facilities, and employment without rsgor d eo room creed color.sc, age, national orgin, or handicap. <br />