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iOahurry <br />C% <br />City of Saint Anthony Village <br />Commission Application Form <br />RECEIVED <br />NOV -12016 <br />Name: `<¢% /�O /3%l�'� cif 4F�� Phone Number: W/Z " 7I <br />Home Address: ��Z� /� /��FfL 74VIE Zip Code: <br />Email Address: (--) /_ / o., __ <br />Please circle which commission you are applying for: Parks Planning <br />In order for the Mentor and Council rnenibers have a better understanding of your background and <br />interests, please provide the folloudug information (attach extra sheets if uecessanl). <br />How long have you lived in St. Anthony Village? Z{) years <br />Why do you want to serve on, a St. Anthony Village Commission? <br />ITAo&Vwrj �l�rllri75 i • ._4TI�'1 (`I y <br />Please list your prior experiencing serving on a Board or Commission, etc. <br />—1`6L--� <br />"All applicants are required to be a resident of St. nthony itlage <� <br />Fora�irc xrr onh' c�h� u \ <br />C�i'Vl )uc Recuved: <br />