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<br /> • APL'LIC:A'TIc.)N FOR ADVISORY GROUPS
<br /> •
<br /> r up Applied ['i r: --
<br /> rAR, �n�D c_n__E�?.nav �f)/tf Nisr/o Al '
<br /> Second Choice ( if any) :
<br /> Full Name (print o r type) : — — -- ____
<br /> Address :
<br /> -_-`--
<br /> 70 -- - skiln ctW ao-0 ORivg
<br /> Year:; At. This Address : Years You Have Lived In Mounds View:
<br /> 77 ys
<br /> TelephH
<br /> one: ome: - - Work or Other:
<br /> ---- 786-3417 7 ----- -- - -- --- 6.2V-9.73/
<br /> QUALIFICATIONS YOU WANT TO HAVE THE COUNCIL CONSIDER
<br /> Ski .11.s and interests :
<br /> �NJey al/ Iiceis a F OSdeoi' tee',ra_r,o J
<br /> Al/vc a. .vent low rem-- Wu ow aii/'.s
<br /> NAU_e. two X east b a-sie 6Q 4Pna�� tat o/Yit rata//111444 e '.
<br /> Employment, Occ pation or Other Experience:
<br /> I/,Fcoy.ff.ef: •
<br /> 79-110-Gt or Da/t.�. Ale*, awl �4 a"
<br /> v
<br /> 3/eie, Prsvlt Gln,o, e//i n. A' 40,0 Nvrf+taQIu t,. icresfry Ato// Sea.,'clam-�,
<br /> *l,,-361, - 7' ' >' /Oursory, S/. /`�•Otlt, /`i,,. 77 .-- 4' e.C.iy oeAlauua44.3
<br /> wry, /p,,-/'feetnf A�6or Alin Sir y,JAI...id,,�de4w,Z-eu0A en? Forester.
<br /> - Abdue/14:,31144)140 /t a ttetid sAra 61
<br /> Memberships , Accomplis �hments Or. Other Qualifications :
<br /> Edi,i44770.e1•'
<br /> 1 /cwt. a- k
<br /> qe wordy IWev 4
<br /> /o 9 - .s- FYr s 7- ki�so,,«ca,
<br /> an ,.
<br /> t). of /yu�J. (/ 4nd eut -e.41 9.tQ.IQ E a-sad �j0./.t[.rod
<br /> /9Q/ - /"1.S. LIAe4.c.) F,AtIr, / C� -coal fe-k. 6.47/.344.gt au`ei-oe
<br /> — a nit). .o{ Hoo Ale-sof-0 lt, A
<br /> Please State Your Reasons For Wanting To Serve On This Committee:
<br /> NY- t "�411°'`!4 Yea- a t dere-e,o et 920V dat-g_ J £a4 Lee(
<br /> e:24,0 ..
<br /> . cudu•a-cciel.- e+u.
<br /> leas _ 142 op 0LtaM/CUAS d d ., 7//-- 4 YA '
<br /> 114.4. ccta-4 oti A 0C-C1-u. 1 444ttdd yu / „ L . dr► ,
<br /> Your response to any of the above may be continued oo nUthe ack
<br /> and you may attach any other materials which you want the Council
<br /> to consider.
<br /> – 4444 --- --
<br /> S i g n a t•a r , et ,GLt, `'' _- –
<br /> Date //,r
<br /> The C y of Mounds View is cc mitted to the policy that all
<br /> persons shall heave equal access to its programs, facilities, and
<br /> employment without regard to race, creed , color, sex , age ,
<br /> national origin , or handicap. -
<br />
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