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APPLICATION FOR ADVISORY GROUPS <br /> Group Applied For: 11-- <br /> Second Choice (if any): <br /> Full Name (print or type): <br /> R EEN JAN R3 ZissA'A\GIN <br /> Address: <br /> s IR- Coves �� 1`a� A 14 <br /> ( <br /> Years at This Address: Years You Have Lived in Mounds View: <br /> 1'1 (02 e t c/ io n ►ei ci <br /> Telephone: Home: Work or Other: F6-'s (°1 z-33 e- ( 357'7 <br /> 612- 3-92. - 02 ( GiZ -33 -/577(0 <br /> QUALIFICATIONS YOU WANT TO HAVE THE COUNCIL CONSIDER <br /> Skills and Interests:a kap 4-434zk`8 u"A � C'; ‘1 .4.7N 'sh�";n (3us e s4 2`�;��" <br /> C9u ,•Jirk5) 0u iOht-c..�cr?c cl�.ukatoemcn.� 0� i11411-tvo,v i?Iac.� iv-, r"\ ). ------)--) 1 <br /> -f0,4:(4 c -kcwi f 142Kiw.Si 54ke 4 ItiM-S TiVz p1c,wAi,.) <br /> r ti -}`-nt s4s o)cam. ` b Y) ---) <br /> Employment, Occupation or Other Experience: <br /> =Wk. 5ef- ervylcwfc` 'r..+ s-‘. :. Pic -k1/4.4.€: -cZiavvn; w r�...� <br /> F IV E. �2"‘- 13 u 5;au r S S ( :fl2 H( (Zrn o- -I wc-t=) <br /> Memberships, Accomplishments or Other Qualifications: ;N //A'iv N t=ao t ;S <br /> Fo1/4.)A...6aiior.., ZoAvlctPALmotilt. 0c �IS COM Mur�iiy °��ccj c ( CA�:IC <br /> UNiverisi ii o-C 5` 0,As (,+yp 15 captf�'}) A64i n2Y C.:mr+,rt1 : l <br /> ;tv�r of �s —NtNN if'', t-!ARrvtc.Ci Lc>";.� Gomrh,• c <br /> PleLase State your Reasons For Wanting To Serve On This Committee: ` <br /> J. K\Ptvif MA4C A� majo(Z 1n�Nc7iMin,� in.. r , hem A-,,A, . plA...uOw tiv:nJ <br /> 1\l at Mos 4 04. M�/ !, ,;. a u- Ar..-4 4-0 � -tto rdsA►Ct i i\voky� 5 viLw-0,,- <br /> P IA c� Pc3 f l r u_Av.A. -k Li u t i ru SQ- TiZJA (-Ci ;� <br /> <7 i 5ilcwA(k(, 0UL1r�--7 <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 (\(/ A___ �-� Date /a -; - t <br /> The City of Mounds Vie 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 />