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NEW <br /> BRICaiTON <br /> the city that works for you <br /> Advisory Commission Application <br /> Date Z ` I <br /> General Information <br /> Name -Cc �,,�e`tt1\ <br /> Last First M.I. <br /> Address ( ) er 0,Act C4 <br /> City, State ZIP k ;4C) `�5 4-e ( <br /> Phone �� I 9 W _ ` � kkke, <br /> Home Business Cell <br /> Email Address S c.V �� �n K Ce, c��� = '_e-4 <br /> Commission/Task Force <br /> Public Safety Commission Economic Development Commission <br /> Planning Commission Civil Service Commission <br /> Park, Recreation&Environmental Comm. <br /> Availability (Check all Preferences) <br /> After work, early evening Evening, after supper Early morning <br /> List specific days or times you are not available <br /> Personal Information • <br /> List any related work/education experience: <br />