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LMM <br />APPLICATION FOR ADVISORY GROUPS <br />Group Applied For: <br />Second Choice (if any): <br />Full Name (print or type): <br />G <br />Address: ^ �� � / v % S <br />Years At^^Thiiss Address:,(, Years You <br />Have Lived In ?rounds View: <br />..?r Y�iGL� <br />,i'i Y_ �Lti <br />Telephone: 'Horne: <br />Wor or Other: <br />Ze$L 27e1 <br />79!/y,73a <br />QUALIFICATIONS YOU WANT TO HAVE THE COUNCIL CONSIDER. <br />Skills and Interests: <br />Employment, Occupation or Other Experience: <br />r� 11a/, <br />(-tIMOt a 7 y 1,3 <br />Memberships, Accom lishments Or Other Qualifications: <br />Please State Your Reasons For Wanting To Serve On This Committee: <br />v�lQ.4�✓LK iL1.LiLi t/.�I�L �� o•I �(�GK �Ytj V.(.� , <br />nn Fhn hack <br />and you nay attach any other materials which you want the Council <br />to consider. j L j I <br />Signature Date <br />`�V i <br />The City of ounds 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 />