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APPLICATION FOR ADVISORY GROUPS
<br /> Group Applied For:
<br /> FLaw040i6 Commrss;orr
<br /> Second Choice ( if any) :
<br /> Full Name (print or type) :
<br /> tC 4 R4 0. O mAN
<br /> Address :
<br /> '76aOS 6R0\16LRpoFla
<br /> Years At This Address : Years You Have Lived In Mounds View:
<br /> - 3, 5-
<br /> Telephone:
<br /> Telephone: Home: Work or Other:
<br /> -786- 675
<br /> QUALIFICATIONS YOU WANT TO HAVE THE COUNCIL CONSIDER
<br /> Skills and Interests : 2 am cx16e)ENccd %N Ti's PRocEss of OOhvr,i55/LW
<br /> ,cTl1/Ir1E$, dfN A0R,t" 1.06/1 IA;i -i. 61-116g 51 er?/i 6 .ec,5c- SCONd "56m6NT hfv6
<br /> 097V 6,01 rn,,vd, 49M J r q 1.1 A TO eoNt ; J7F .TO 0 V Cr;T)^.
<br /> Employment, Occupation or Other Experience:
<br /> 01 !
<br /> YRS, iN (OMs/Rua-M. g Cie/4 >y yq5, R6nxd7i,N3 eoNnRAcrOR, CCI WTOinc.:d TO
<br /> sldc�NT/!,�Z mfNis. rftrndm'A ld/P1 All
<br /> Ph
<br /> /�RA�r> {le s d� POmmfRtlAL� RF , OTFR Della
<br /> P un+cl,C15Ts 4. nomplfTie;v.
<br /> s3es o f P!{ov fc;s� FRom ,oi/?�NnNS d- PFRn»TS TO P
<br /> h,thy TO ',Meg 711)1d 61orpR„rTY 4. eOn+TAPer Dc'eomeNT5, eTc!
<br /> Memberships, Accomplishments Or Other Qualifications :�l
<br /> A A 1)6 REE - 02,NA/6Ra'L,s (tommdn�J 1J Cc>le , /noiNo>5 1/1et,/ ehRRT6-1 eon m,Ss'w
<br /> MEmh OI j'Q dF movrds Ui'& e.N✓f,a.vir,F,vTsc QRt;T1> Poma,rss:o:✓
<br /> Please State Your Reasons For Wanting To Serve On This Committee:
<br /> 2 of7.4v Abet'T OR CI'Ty .9No' i7c FvTuRF` ,lyd 1 & /,Fw tA. T my
<br /> a•, 1/S /9 V d 6X/96RkEA✓e.f a/0a/(/ <iv/ ,r r i F 0;7-y f),9 tirlm; 5 mVn>s slaty,
<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 Council
<br /> to consider. /J
<br /> Signature � ('7�n��r, Date a - v
<br /> The City of Mounds View is committed to the policy that all
<br /> persons shall have equal access to its programs, facilities, and
<br /> employment without regard to race , creed, color, sex, age,
<br /> national origin , or handicap.
<br />
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