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<br /> • APPLICATION FOR ADVISOR`_' GROUPS
<br /> Group Applied For: p ^ ,!/�
<br /> 16_4 Li •i" fio-7, _i -74.
<br /> Second Choice ( i.e any) :
<br /> Full Name (print or type) :
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<br /> Adores : t r , P,,,Z-
<br /> :,:ears
<br /> 1J// C-i ‘f /;,'i1.'',3) - -Ac This Address : Years You Have Lived In Mounds View: _
<br /> // /A,' /11-% .S•a 1/47 w
<br /> Telephone : Home: . Work or Otter:
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<br /> QUALIFICATIONS YOU WANT TO HAVE THE COUNCIL CONSIDER
<br /> S_ ' is and Interests :_ i ".- y�' r) X61) .� /
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<br /> E_:�p ' evme' t, Occupation cr Other/Experience:
<br /> /t=er/Ex:e=_ence: • f J
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<br /> Hem/be:sn_ts , Accomplishments Or tier Qua'if icat�� ns /,( 6 -�,=, '7Y-;T_., • 4'
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<br /> Please State Your Reasons For Wanting To Serve On This cmm' `- ,, :
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<br /> Your _� ;Cnse /to any of the atove may to cont_.nuec cn the back
<br /> and vcui :Tray attich any other materials whit~ you want the Council
<br /> to consider.
<br /> Si attire (J� ) ✓- ( / ,/
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<br /> , .�J '°_: Cate / ? r C
<br /> 111 J?T-
<br /> ?":e City cf Mcunds View is ccT.I^.'_ -ted to the 001iC7 that all
<br /> cerscns shall have equal access to its crcgrams , facilities , and
<br /> emclovment without regard to race , creed , color, sex, age ,
<br /> nat_cna_ origin , or handicap .
<br /> 1111
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