10/22/92 Agenda & Packet - Laserfiche WebLink

Home Browse Search

CITY OF MOUNDS VIEW 2401 HIGHWAY 10 . MOUNDS VIEW, MN 55112 (612) 784-3055 APPLICATION FOR ADVISORY GROUPS Group Applied for: �f ` Frh-oit) ' �R y Second Choice (if any): Full Name (print or type): Z/ 44 , n, 4 opRn r,y< rk 44,CI j, Phone: Home: 7 3 —0 Work Work or Other: 3 Y5-3 5137 Address: 76 3 5- w 00 N U k. 03 /)'1 O ctivcis o f w , i 7"1 ,Vs;� /7_2- Years /2Years at this Address: L{ r o. Years You Have lived in Mounds View: '-/rYo QUALIFICATIONS YOU WANT TO HAVE THE COUNCIL CONSIDER: Skills and Interests: Z IN tot) rjtR -t- .t 0 `A tR K5 ��g`e=*R`1 • -1-- 1 cR F\--t o tJ '► o -rh i S P R-e P A t^5O I h f U.>z n w 1‘v rM 6e--‘& -j- h srt o 5 std. l 6 InseL f txA o f n-)cJ Employment, Occupation, or Other Experience: _-s- N 3'2K V“‘8. ' - INPLD11)-t 1`)--PP1/40(5 le-eeReP•t.`tb/il ) Fog-e-tR , S,- LOo?K o 106R6-1-Pst WoQ_Lc\L' l., tK z GP t v -etre drhePs 5�1- Memberships, Accomplishments, or Other Qualifications: Please State Your Reason for Wanting to Serve on this Committee: h -� Art too ► c\) 4 P dC r NS 0 un. s Zt.� \.,J ' • c 3 p.s C o qv�Mu N'-k-tf —1'o �. (Le. � N A t,S c� t)n L'L dp L. -R -to h L? i & F t Y o (We Your response to any of the above inquiries may be continued on the back and you may attach any other material which you want the City Council to consider. Signature: Q QQ ,,,1 - Date • The City of Mounds View is committed to the policy that all persons shall have equal access to its programs, facilities, and employment without regard to race, creed, color, sex, age, national origin, or handicap.