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i <br /> City of Mounds View <br /> 2401 Highway 10 <br /> Mounds View, MN 55112 <br /> (763) 717-4000 <br /> I <br /> Application for Advisory Boards and Commissions <br /> Group Applied for: <br /> Full Name (Please Print): <br /> Home Phone: Work Phone: <br /> Address: <br /> Years at this address: Years you have lived in Mounds View: i <br /> E-mail Address: <br /> Qualifications You Want to Have the Mayor and City Council Consider: <br /> Skills and Interests: <br /> Employment, Occupation or Other Experience: <br /> Memberships, Accomplishments or Other Qualifications: <br /> i <br /> I <br /> i <br /> Please state your reason for wanting to serve with this group: <br /> Signature: Date: <br /> (Your response to any of the above inquiries may be continued on the back of this forrii and you <br /> may attach any other material that you would want the Mayor and Council to consider.) <br /> I <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, creed, color,sex, age, national origin or handicap. <br />