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1111 <br /> APPLICATION FORVISORY GROUPS <br /> P_ AD <br /> Grout) Applied For: 0 ) <br /> at-Kc and (', (rtrrin;z <br /> Second Choice ( it any) : <br /> Full vase (print or type ) : <br /> Sherr ( 7 unr <br /> Address : <br /> S'rcpec ( nKCo -t-- <br /> Years At This Add ess : Years You Haveved In Mounds View: <br /> Telephone: Home: Work or Other: <br /> QUALIFICATIONS YOU WANT TO HAVE THE COUNCIL CONSIDER <br /> Skills and Interests : <br /> a m V Or (.1 CA--; v' Com " ;iJ 4 e w c G ei , / i t g c''i"k< <br /> 64., r k:,z,* LL;, 1, re e ct d,'t cy pre ,'C(rri 5 i•,&.:246\ CLa7 rKde � �. CC c,-,d /SLC „, <br /> •, ,t rr: -� Kf%_./0_1A-14, k •. ter• �`� ;:.11�'` ° ' rc�r:i�c-i.: J <br /> mp1ovmentJ Occupati r Other Experiences - J;" <br /> --1-- Loo c v„Q8 GST �k.f\c j Cb - d\ 1 q W CL'l6 -S:Lv-Ask', C L,.� CL d) <br /> r `� <br /> Q \ti\C_•:\ C'_:�2 C-. CL "1-t-=O� 4'\ t • l,c., be i n ` C1 Pc-c)'a• Gkry i`ik.e S <br /> 1110 <br /> i <br /> c� T 110 r 1�. 0* �1c9wc;GC( ►n ` CS Q <br /> 1 Ct 4.: Cc rc"�v( d TCLCC L a <br /> ;!empersni JAcccmplishments Or Other Qualifications : <br /> 4431.fs`E' 4,0! "k 3ictL A4'E. i-c.0/0Sf a3s;,+ c. - 1 C1�, c. eft_ ,__- <br /> q(i L(^,i& C. r -v() r'ri!�t7?b_ _ yo,71 € c.,...•C°c,d i// ' J c 1•"e'- Gr ecCt_ <br /> J / <br /> L c .c r�U C." ; Ct-t- ?r n ec....'C-C., C C: kl—€ ' A- VC C v%l�ee.t' (.L'C%`k <br /> �� ,k� to <br /> Please State Your Reasons For Wanting To Serve On This Ccmmir : <br /> 4. d -4"h ai--- LA).,e a 5 C{ CO ill fY\ c:,A-t 4-4 11 a ue c{ <br /> r ` l 1DC'r j i b i 1 i •K , i-c[(, l.;1 CLL -7`L- t i S 1 }'_1�!l{'r C\l'k�.._(', <br /> Ci / 1d Sc Ci '(.11--). <br /> 'f G./4----i-y-' 1.‘}/ A1C. r"_ - 1 /':/1 rl/riI ri1 q 7-1 C± /\ Oa Ck) <br /> Your response to any of the above may be continued on the back <br /> and you may attach any other materials which you want the Councill <br /> to consider. / <br /> Signature 4,4 ;7 .4 c�1_/YviA__/. Date ( i / .l of <br /> i _ 1 / <br /> The City of Mcunds.iiew is committed to the policy that all <br /> persons shall have equal access to its programs, facilities , and - <br /> emplcyment without regard to race, creed, color, sex, age , <br /> national origin , or handicap. <br /> • <br />