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APPLICATION SEP 0 i <br />MOUNDS VIEW CHARTER COMMISSION <br />Mail or e-mail completed application to: <br />Laura J. Stevens, Probate Registrar <br />170 Courthouse, 15 W. Kellogg Blvd., St. Paul, MN 55102 <br />Laura. Stevens @courts. state. mn.us <br />KVS S�, L <br />Full Name (Print or type) <br />!\UUICJ.l. <br />wae <br />wHr I W ( A — <br />Years at this Years you 'leave lived City Ward/Precinct County Commission <br />address in Ramsey County District <br />.763 (3ft a^g- If IV-ry ssd et <br />Cell Phone Number Other Phone Number E-mail Address <br />QUALIFICATIONS TO BE CONSIDERED: <br />00 <br />Education: <br />ry -i <br />Employment, Occupation or Other E eri ce: <br />ftvkv� DS Aodc' <br />Memberships. Accomplishments or Other Quail <br />Cum &0--LrL COAXAWN <br />G <br />ons: <br />Please state your reason or wanting to serve on this committee: <br />flJS'1i1:'^4 04 <br />0�-C <br />Your response to any of ie above may be continued on the back and you may attach any other <br />materials which yo m want considered. <br />E: SIGNATURWA)-- DATE: <br />Mounds View is committed to the policy that all persons shall have equal access to their <br />programs, faeilities and employment ivithout regard to race, creed. color, sex. age, national <br />origin or handicap. <br />C"Orv, <br />