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N <br />IVNEW VL <br />BRUM <br />the oily that w As for you <br />Advisory Commission & Task Force Application <br />Date (� <br />General Information <br />Name � IV I L/L <br />Last22 First <br />Address l �� �Jroi <br />City, State ZIP <br />2 <br />/4 <br />// Z <br />t� <br />Phoneo5-1+36-�76V 612-Z7 /V/7 �/z-7�/-6��3 <br />Home / ' / / Business Cell <br />LI <br />Email Address !1(6L `� DCY���dSC... • e Dn� <br />Commission/Task Force <br />Public Safety Commission <br />Planning Commission <br />Park, Recreation & Environmental Conon. <br />Availability (Check all Preferences) <br />l/tvtter work, early evening k ---Evening, after supper <br />Economic Development Commission <br />Civil Service Commission <br />NWQ Financial Strategies Task Force <br />Early morning <br />List specific days or times you are not available rs �Gl�y &' s <br />Personal Information <br />List any related work/education experience: <br />