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. <br /> APPLICATION FOR ADVISORY GROUPS <br /> OR COMMITTEES_ i_ <br /> Name of Group or Committee app .lying For. Ziqb <br /> Second <br /> Choice If Any): <br /> Full Name (First,Middle,Last): JRtiiUy b 9 <br /> t; e0,4-/ <br /> Address: e 9 Pleasa m 1i/e Q 4T / -€ <br /> Years At This Address: .S <br /> Years You Have Lived In Mounds View: S <br /> 7 Work or Other: <br /> Telephone Number Home: 9$ _(j GAO <br /> • <br /> . QUALIFICATIONS YOU WANT THE CITY COUNCIL TO CONSIDER <br /> Skills and Interests: • • <br /> S4---/-2' <br /> y/ <br /> Emplov�_meat, Occupation, ��ence: <br /> /91U aZOd 49 <br /> - Memberships,Accomplishments, or Other Qual fications.: <br /> Please State Your Reasons For Wanting To Serve On This C mittee• �/ tiv � <br /> �/rn-� G' � �L,�,,.� �, ,� ,,,�. .�.�^ /flcv-cam Gc.� <br /> �.V 16 �2Cid O '--c <br /> continuer on :he hack, and you may attach. any <br /> Your res�onsz :o any of the above may he _.. . <br /> oti1er mate-.his <br /> which you want the City Council :o consider. <br /> c_21_1„--7//' �,� Date <br /> C iQ*13t[:re ./72 �1 ' <br /> ;vile '.hat iii persons shall 'gave equal access :o its • <br /> The City or'ylcuads View is committed o the ' awe �cnai <br /> programs, acuities, and emoiovrnent without ;etarc :o race, c: Cour, sex. ares <br /> orimn. or handicap. <br />