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HomeMy WebLinkAboutParks and Recreation Application - Gerald ArelCity of Mounds View 2401 Highway 10 Mounds View, MN 55112 (763) 717-4000 Application for Advisory Boards and Commissions Group Applied for: .I� �(�e C ©�,- rY, r j Full Name (Please Print): Home Phone: r �� ��. Work Phone: Address: _ � r,\ WO -0t> Years at this address: 2p ____—,Years you have lived in Mounds View: _z E-mail Address: I � � 9 a _ M � "i - C O tM Qualifications You Want to Have the Mayor and City Council Consider: Skills and Interests: (,)i4c 1jSS P `'4' ( A�j1 6,D I r� ,? ) e,,-,/�� r �'r -Z6 L IUs 3j�) �icr y6u4. nem to r 0) 4 l-2 fib, An-�- Emp oyment, Occupation or Other Experience: A" 0S � �0�` �J G)e e,? a Memberships, Accomplishments or Other Qualifications: r =f r Please state your reason for wanting to serve with this group: �✓�I GS/ilUf fUY cur r� Signature:._ Date: (Your response to any of the above inquiries may be continued on the back of this form 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. �n_1g-06 P01:[E1 IN