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W-E/ir q..,3 i <br /> 4,„3031 a.,,, <br /> : 40 4 ,or ' . <br /> s% ep : : <br /> APPLICATION. FOR ADVISORY GROUPS file -9" <br /> �L '� p ? <br /> y <br /> Group Applied For: / ) .` ) ' <br /> . :%c ,r)i-) in o ( 1)n-)in l:S_S i U �' A <br /> Second Choice ( if any) :-. a 91,0 ' <br /> K <br /> Full Name (print or type) : ��a n bi L + 5-1--- otn.scri <br /> Address : <br /> g , Li 7 t- P-rdal, <br /> Years At This - dress: Years You EIave L� w <br /> Lived 5- <br /> Mounds Vie <br /> Telephone: K me- l____7o- k r 0 h <br /> 7/7.78 <br /> QUALIFICATIONS YOU WANT TO HAVE THE COUNCIL CONSIDER <br /> Skills and Interests ; `/zn , <br /> / /j Cin /� �Csyf�; hl S mcii. a ' Ci.�.. <br /> O C z r 2C rC ct�z i"6 C~.n . . rr <�.t/ <br /> Em loyment, ccupation or Other Experience: U <br /> � Y <br /> li li 5 . in US/r) e-5:3m,,-),VTa_ l of) <br /> Sj-1 .Q/-ri pl uc.e. 05 panc,(46d-Lere.,_ r3 Sca./e <br /> p-2 pf-'6- of (- .) ,1(�4 �S: <1r� G ln ()(1C-�'S )h n/( S <br /> Memberships , Accomplishments Or Otter Quali icadions: <br /> aJ <br /> r�r"C:�n J(u U Y 2Q C� CarvrLc%)c)-(:_6 <br /> . rn.Qe. ';4� /2C- )-6 C/(thin C. C Cys_. <br /> -7-cery _r 12rajZfsn t-6-1 Pc.:tili iple fit rc-).,r) .. <br /> Please State Your Reasons For Wanting- To Serve On. This. Committee:. <br /> t\is • Cu mC-t0 T /S 7y)q 1 9��L ' 1 �rn � h. <br /> 'rY irat ,,,(, 70 h-4111 7 i `-1 (-t_a/;7`Z a? ^'' C .7)(?0L.474(34 <br /> 00:_u . [ I--n 0-{--ci,--,,,y,L1 /() Li/6( _._/ <br /> ov(7--6---- 04-1, (dr, baciO\ <br /> Your response. to any of the above may be co' inued on the back <br /> and you may attach any other materials which you want the Council <br /> to consider. <br /> Signature YI)-t _.- ... /teA-1 'i',4 ,, Date ‘ " y '-' / <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 /> II <br />