HomeMy WebLinkAboutBoards and Commission ApplicationCity of Mounds View
2401 Highway 10
Mounds View, MN 55112
(763) 717-4000
Application for Advisory Boards and Commissions
Group Applied for: ___
Full Name (Please Print):
Home Phone:
Address:
Years at this address:
E-mail Address:
Work Phone:
Years you have lived in Mounds View:
Qualifications You Want to Have the Mayor and City Council Consider:
Skills and Interests:
Employment, Occupation or Other Experience:
Memberships, Accomplishments or Other Qualifications:
Please state your reason for wanting to serve with this group:
Signature:
Date:
(Your response to any of the above inquiries may be continued ori the back of this forrii and you
may attach any other material that you would want the Mayor and Council to consider.)
The City of'Mounds View is committed to the policy that all persons shall have access to its programs,
Facilities and employment without regard for race, creed, color, sex, age, national origin or handicap.