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APPLICATION FOR ADVISORY GROUPS <br /> • OR COMMITTEES <br /> • <br /> • <br /> Committee lying For:Mame of Group or C PP Z'tb <br /> Second Choice (If Any): • <br /> Full Name (First, Middle,Last): f)1i,vi-'y L w/347i, ),)%,„<,/ <br /> Address: 6 97 an P/ea;4 i7T <br /> Years At This Address: .5" Years You Have Lived In Mounds View: S <br /> Telephone Number Home: 9 r3 LSO?7 Work or Other F <br /> • <br /> . QUALIFICATIONS YOU WANT TIE CITY COUNCIL TO CONSIDER <br /> Skills and Interests: <br /> • �4..2�. <br /> EinpIovmear, Occupation,or Other Ei-perience: <br /> .5-4---4-",t2/1141--U% 149 „Adi/A ./41-geAr- 111U 6.1-4'40 <br /> p unlificatlons: //Y <br /> Memberships,Accomplishments, or Other Q <br /> ‘1 /, G4 <br /> Pease State Your Reasons For Wanting To Serve On This C "tter• r� t <br /> 44 �� "� "`' 4, v <br /> SCC Chi 4,270-a. ti —.r`vswl d� c.4 a `'"t <br /> 1 <br /> Your response to any of the above may be continued on :he back, and you may attach any <br /> other azateriais which.you want the City Ccunci :a consider. <br /> 7), <br /> � Date <br /> Surat <br /> that ail persons wail have equal access to its <br /> • The City of Mounds Vie:v is committed to the ?oiic: o creed. ccior, se"` �Qe, aationai <br /> programs, 5.cilides, and.emoioytnent without cerrd.:a race, <br /> origin. or handicap. <br /> - , U <br />