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slt-17-1-"Y A li <br /> . _ <br /> II <br /> _____ .- -_--- ----- APPLICATION FOR ADVISORY GROUP:;' _ <br /> Group Applied For: <br /> f A�k� - 1- ntc C.n.CAr%nni (OYv)ir1/S5r011 <br /> Second Choice ( if any) : <br /> Full Name (print- or type) : <br /> /11/120/4 U n g r AA/Mk-S(11\1 <br /> _ <br /> >C,13 C /Awy (0 tt --?,62._ PYou kv).s YW ,, tliA <br /> Years At This Address : ! Years You Have Lived In Mounds Vjew: <br /> Ti —Home: % 1l� Work or Other: <br /> 1 go I <br /> QUALIFICATIONS YOU WANT TO HAVE THE COUNCIL CONSIDER <br /> Skil.l s and interests : ---- --i-- ---------- - <br /> aUtDooft, Co)2-rs i (J,RI-1--)N\6 i Rt ' , )1r 6, <br /> ' Employment, Occupation or Other Experience: <br /> Ct/Pl1:;a r MA-57)A) <br /> • <br /> Memberships , Accomplistrments Or Other Qualifications : <br /> UoAS (..1..(nf., -- (.AU.? At:6A6 Avv\W r b) I <br /> (L1\v C 012,E-,A N ! zt'n Ant Cr StI-r&P LA- Lk 76u-iA S ,n� <br /> 1)bUl..6-, c. U , , WI, <br /> Please State Your Reasons For Wanting To Serve On This Committee : <br /> 10P-- 1 01-crcv I N P.M Aru I n s Po P-rS. A n)t u s <br /> Tor CAe--.g Wilt 1 " Y #'Nvyt?c y , or ArPneciPt'6" MO 4 6 <br /> tie. ()Aims 1-u fE-, ncSo It ex,4,tolAc mUot. feb no tNE - <br /> Your response-to any of the above may be continued on the back <br /> and you may attach any other materials which you want the Council <br /> Lo consider. <br /> Signature 11/61:-___L_ t � ----- Date /a-- /4, -- A <br /> The City of Mounds View is committed to the policy that all <br /> persons shall have equal access to its programs, facilities , and <br /> employment without regard to race , creed , color, sex , age , <br /> national origin , or handicap. <br /> • <br /> i . <br />