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APPLICATION <br />MOUNDS VIEW CHARTER COMMISSION <br />Mail completed application to: <br />Michael F. Upton, Court Administrator <br />600 Courthouse, 15 W. Kellogg Blvd., St. Paul, MN 55102 <br />DwAjL1 s CA a r4 <br />Full Name (Print or type) <br />2,90 Calm; Road F4 2, mounds V1`&U.7. MN -55112 <br />Address: <br />2 yea r -.s 2 years MV 17kci htO <br />Years at this Years you have lived City Ward/Precinct County Commission <br />address in Ramsey County District <br />_ <br />6,51-75S-00-1.5 (r -J) 761- 291- 6328 (aA td) <br />Telephone: Home Work or Other <br />QUALIFICATIONS TO BE CONSIDERED: <br />urriorS r` o� Nlinrreso � . r r-- ergs rAce- <br />Education:' <br />7h Fisher ,Sa;orL*; "c (Cao Ra ids, MN e s IJ2 ylYrs <br />Employment, Occupation or Other Experience: <br />Tufo pec h kl b hq v pa -1 Pp -s <br />Memberships, Accomplishments or Other Qualifications: <br />na is 4c prow"de adyl-M fir es4oQLA1ns tggjvmQ sovirni„9 <br />Please state your reasons for wand � to serve on this committee: <br />pa.�, cl es 'fie r +6 c?iy of Mau -rids View, <br />Your response to any of the above may be continued on the back and you may attach any other <br />materials which you may want considered. <br />SIGNATURE: Ict DATE: August ;?; 2011 <br />Mounds View is committed to the policy that all persons shall have equal access to their <br />programs, facilities and employment without regard to race, creed, color, sex, age, national <br />origin or handicap. <br />