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APPLICATION FOR ADVISORY GROUPS <br /> Group Applied For: <br /> S't`r i'L Corn rn :"Et <br /> Second Choice (if any): <br /> Full Name (print or type): <br /> JArnEs P- <br /> Address: <br /> 55s-6 "5t. . 5-t-ePi�r�cs St ria - <br /> Years at This Address: Years You Have Lived in Mounds View: <br /> Telephone: Home: Work or Other: <br /> S <br /> QUALIFICATIONS YOU WANT TO HAVE THE COUNCIL CONSIDER <br /> Skills and Interests: <br /> Employment, Occupation or Other Experience: <br /> Memberships, Accomplishments or Other Qualifications: <br /> Please State your Reasons For Wanting To Serve On This Committee: <br /> a W G..�. -E o 6.2_ i N 11C 1stCl t,v rpt c c� <br /> cte c c cl.Q O N l hR S S t-f -E p c G v.-0-A^^s C 1 o- 41"Q �. <br /> Your response to any of the above may be continued on the back and you may <br /> attach any other materials which you want the Council to consider. <br /> Signature ti /7 <br /> Date ioI >S <br /> The City of Mounds View is committed to the police that all persons shall have equal <br /> access to its programs, facilities, and employment-without regard to race, creed, color, <br /> sex, age, national origin, or handicap. <br />