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APPLICATION FOR ADVISORY GROUPS <br />Group Applied <br />For: <br />Second Choice <br />(if any): <br />�O h <br />Ful N mee�rint, <br />kk l 0: <br />ti ty <br />Address: <br />7y2� (dial<Llier.�TFFa�� <br />Years/At This <br />Address: <br />Years <br />You Have Lived In Mounds View:— <br />Telephone: Home: <br />Work or Qther: <br />QUALIFICATIONS YOU WANT TO HAVE THE COUNCIL CONSIDER <br />Skills and Interests: <br />n o <br />Employment, occupation <br />or Other a: <br />Mem rships, Accomplishm is Or Other Qualifications: <br />Please State Your <br />Reasons For Wanting To Serve On This Committee: <br />(iee fo <br />Toro e � if��c, f : F' "40ssid /e . <br />Your response to any of the above may be continued on the back <br />materials which you want the Council <br />and you may attach <br />any other <br />to consider. <br />Signature Date Q,kff <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 />ME <br />