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cMpo;nom ctudy Gr Dup Application <br />P I G n n► ng Commission Date 0 o �O/ (39 <br />General Information <br />Name &-L,jr <br />Last <br />Business Name (If applicable) <br />First <br />Or% <br />k <br />� Q <br />Address�� <br />City, State ZIP <br />Phone <br />• r Home <br />Email Address P aA <br />I am applying as a: <br />Business <br />be. Our ca� �k vim. CCM <br />New Brighton Resident New Brighton Business Owner <br />Availability (Check all Preferences) <br />_�'N After work, early evening �—<— Evening, after supper Early morning <br />List specific days or tithes you are not available �� 161 <br />Personal Information <br />List any related work/education experience: <br />M.I. <br />--(0y 59 <br />Cell <br />� ('.,�.nn inn, ,n i�.t \��'' :� (r �('�fVl�Il } %�� � o �� C .��••1 til` ��' . �.�.' , �� � � `: <br />� UNIUL fir' <br />W' JA-1e"'A UJ/ ccfI%Wu',MAAJCf C� 1Y� � • <br />9 <br />