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City of Mounds View <br />2401 County Highway 10 <br />Mounds View, MN 55112 <br />763-7174000 <br />Application for Advisory Commissions and Committees <br />Grou s applied 1, <br />pO pP for: a/L� <br />Full Name (Please Print): <br />1 <br />Years at this address: - Years you have lived in Mounds View: <br />Ex <br />Skills and Interests: <br />alifications <br />Employment, Occupation or Other Relevant Experience: <br />Memberships, Accomplishments or Other Qualifications: ��- ��� <br />Please state your reason for wanting to serve with this grouN <br />Your <br />response to any of the abovequiries may be continued on the back of this form and you <br />may attach other information that you would like the City Council to consider.) <br />The City of Mounds View is committed to the policy that all persons shall have access to its programs, <br />facilities and employment without regard for race, ethnicity, sex, age or physical abilities. <br />