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11-19-2014
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11-19-2014
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8/30/2018 7:18:27 AM
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MV City Council
City Council Document Type
City Council Packets
Date
11/19/2014
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<br /> <br /> <br />City of Mounds View <br />2401 County Highway 10 <br />Mounds View, MN 55112 <br />763-717-4000 <br /> <br />Application for Advisory Commissions and Committees <br /> <br />Group(s) applied for: _____________________________________________________ <br /> <br />Full Name (Please Print): __________________________________________________ <br /> <br />Work Phone: _____________________ Work/Cell Phone: ______________________ <br /> <br />Address: _______________________________________________________________ <br /> <br />Years at this address: __________ Years you have lived in Mounds View: _______ <br /> <br />E-mail Address: _________________________________________________________ <br /> <br />Experience and Qualifications <br /> <br />Skills and Interests: <br /> <br /> <br /> <br />Employment, Occupation or Other Relevant Experience: <br /> <br /> <br /> <br />Memberships, Accomplishments or Other Qualifications: <br /> <br /> <br /> <br />Please state your reason for wanting to serve with this group: <br /> <br /> <br /> <br /> <br />Signature: _________________________________ Date: _______________________ <br /> <br />(Your response to any of the above inquiries may be continued on the back of this form and you <br />may attach other information that you would like the City Council to consider.) <br /> <br />The City of Mounds View is committed to the policy that all persons shall have access to its programs, <br />facilities and employment without regard for race, ethnicity, sex, age or physical abilities.
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