Laserfiche WebLink
APPLICATION FOR ADVISORY GROUPS <br />Croup Applied For.: <br />`— <br />r <br />1 ( ( W e IIIL'I •ri '. I,rll <br />L�l )11 ,1 <br />I <br />Second Choice (if. any): <br />— -- `— <br />Ful Name (pr nt or type): <br />-----� <br />Address; ---` <br />Years At This Address; <br />Years You <br />Nave f.ived Id Mounds View: <br />b5 <br />tl� <br />Telephone: Home: <br />__ <br />work or Other: <br />QUALIFICATIONS YOU WANT TO HAVE. THE COUNCIL CONSIDER <br />Skills and Interests:---- <br />k.v',II I ,, .,�.n�: ,:.)' r(• •I. I: III .(.,, ' <br />(LI �(tt ..�. .:'J.�I�._S, ('(I � ♦'I ((').rr -L'(I wt A: 1 �'/•l (t.. <br />Employment, Occupation or Other Experience: <br />�(�''. III :I I r. rrl (.i'•rll.l .. .- .. (n. � 1', 1'Inn: .I hl <br />Memberships, Accomplishments Or Other Qualifications: <br />rp(I. I •�(.� i •1'IL .'.i1.1 rb.'. <br />•Itl � /.ail. r.r( J;..:(r 'i:r• i(r r, I' f/:It r•//I <br />Please 'State Your Reasons For Wanting To Serve to This CommittLe: <br />VI.L�CLI <br />,�/ I/.� .CI,:, lr. (, rr ((� •(J i( �': tl:'i, l4h/.( /(`i ('•l, <br />Your response to any of the above may 6e continued he back <br />and you may attach any other materials which you want the Council <br />to consider. <br />Signature(',/W(1(/t;Jlt ?; 'i(l�l(•:,il),` Date 1. <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 />