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P114-1 <br />• <br />CC} <br />MOUNDS VIEW <br />ADVISORY BOARD/COMMITTEE/COMMISSION APPLICATION <br />2401 Mounds View Boulevard " Mounds View MN 55112-1499 <br />(763) 717-4000' Fax (763) 717-4019 <br />ink@moundsviewmn.org I www,moundsviewmn.org <br />" First Name MI Last Na <br />Ce r4 <br />Address <br />City e � � state <br />DMnnn Phone 2 Years at this Address <br />3�/ <br />" Email <br />valid email requlredf <br />Commission/Committee Applying For: <br />❑ Economic Development Commission (meets 3rd Thursday at 7:30 AM)) <br />❑ Planning Commission (meets 1st and 3rd Wednesday at 7:00 PM) <br />&Parks, Recreation $ Forestry Commission (meets 4th Thursday at 7:00 PM) <br />❑ Police Advisory Commission (meets on an "as needed" basis) <br />❑ Comprehensive Plan Task Force (meeting dates to be determined) <br />If applying for Economic Development Commission, check one box below: <br />❑ EDC - Resident Representative <br />❑ EDC - Business Representative <br />If applying fore more than one, please indicate your 1st, 2nd, etc. preference to serve: <br />Skills and Interes s PeA <br />GJ <br />G�/e/ / � f <br />Le2 )I <br />Employment, Occupationz, or Other Relevant Experience <br />V VY) � I V- r y, OYI <br />Zip Code <br />-:�5o z- <br />Years in Mounds View <br />S5/ <br />4 4r rum <br />N- <br />rs--44 f <br />1 /2 <br />