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lk�—' q <br />r <br />APPLICATION FOR ADVISORY GROUPS <br />Group Applied For: PAk9K J- RE(_P.0Airon► <br />GoYvmrssrv,J <br />Second Choice (it <br />any): <br />Full Name (print <br />or type): MA2',A/ <br />VA,{' <br />A06/yonj _ <br />Address: �leG <br />NWy to It 7�6L <br />WwuI�bs YW'j >h►J <br />Years At This Address: I Years You <br />I-L <br />Have Lived In Mounds Vlew: <br />l J1:�_ <br />I'relepion ec i[Eme: <br />7W-b(Ui <br />Work <br />or Other: <br />OUALIFICATIONS YOU WANT TO HAVE THE COUNCIL CONSIDER <br />Skills and Interests: <br />Ouj­poo►t SPva.?' , W(Z,t'iN6� R pGja��jju r�N <br />Employment, Occupation or Other Experience: <br />P ejM 1J7' MASZAl <br />Muwbers6lps, Accomplishments Or Other Qualifications: <br />( jaAS CLuPr -CAr�' fAMA6AnJ�a IA) I <br />'IAVC 0126AAHZeP AUuc.T' 5 r&P&L LCA6u�S la <br />Ubu GwQ' GT`/, �Wi. <br />Please state four Reasons For Wanting To Serve On This Committee: <br />A^ti Itsrma-'CD 1 N i ni (ura Spo kr( AM> us'- <br />_,g` PA(zr3 (, mi my (WC A►'P2Cctp r&- mum <br />fiNE PAP" I-Hc.Rl�, AZSo It MC-61KC 1NVoLUrnmuA7r1YN� <br />Your response to any of the above may be continued on thY. <br />and you may attach any ocher materials which you want the Council <br />to consider. <br />Signature. -_�a Date /a'- /,o _ i7 <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 />cmp.loyment without regard to race, creed, color, sex, age, <br />national origin, or handicap. <br />