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APPLICATION <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 />D-eti', , S lam- L ''tGtcS®ti <br />Full Name (Print or type) <br />— � 1 -7 s^ Tz r,7c-r— IJ �� �mlsv1�� /L)',17 <br />Address: <br />40 70 1 <br />Years at this Years you have lived City Ward/Precinct County Commission <br />address in Ramsey County District <br />7 6, 3 - 71L)- 4) -"'0 4t <br />Cell Phone Number Other Phone Number E-mail Address <br />QUALIFICATIONS TO BE CONSIDERED: <br />Education: <br />I n �uSr�,'4I IlclJ�r� �-t.so., <br />Employment, Occupation or Other Experience: <br />n��;};bershi�s, A;;c�n�I�Iis1�,i�cTtEs o�- Otltcr QttAiif�;ati�ns: _ _. <br />bc— i w,-i C.r` i-i Pyoyvc.SS <br />Please state your reasons for wanting to serve on this committee: <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: - DATE: �� 7-� <br />Mounds View is commille(l to the l)olicy that all persons shall have equal access to their <br />1)mgroms, facilities and employment ivithoul retard to race, creed, color, sex, of>e, national <br />origin or handicap. <br />