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APPLICATION <br />MOUNDS VIEW CHARTER COMMISSION <br />Mail completed application to: <br />Laura J. Stevens, Probate Registrar <br />170 Courthouse, 15 W. Kellogg Blvd., St. Paul, MN 55102 <br />�4U ��+y' c�a���S S��wil <br />Full Name (Print or type) <br />26t coun <br />Address: <br />i kixd 1.42, maund3 Viet <br />MN C. -55J rz <br />V prt y i n �i 3 <br />Years at this Years you have lived City Ward/Precinct County Commission <br />address in Ramsey County District <br />6`715 N�bb��� 76.x» 2 1 J'' % 3 28 a t to. YA 0 Ile <br />Telephone: Home Work or Other <br />QUALIFICATIONS TO BE CONSIDERED: <br />Univ. e - MN <br />Education: <br />S Q A el -0 Er° -q i�� <br />Is <br />Thermo r' hert-o sc-:118n, I C", <br />i, " 'r, <br />Employment, Occupation or Other Experience: <br />two <br />Memberships, Accomp <br />Cyan R%Aid <br />M <br />3$ yEars� <br />ents or Other Qualifications: <br />my 4c4t`rL d�' i0 prbq(4g. 1 n <br />I n fl nfQh1 <br />npW VEi"trC(�- <br />r%+ o'F rPto00'#"h'i'0 <br />Please state your reasons for fvanting to serve on this committee: #- <br />t <br />96v��'� j �� Pii*WS 01" <br />Mound. <br />Your response to any of the above maybe continued on the back and you may attach any other <br />materials which you may want considered. <br />SIGNATURE: �4�L� �+ t���l� DATE: ALI�iG�� �� <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 />