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dyof <br /> \EVV <br /> BRIC�PON <br /> the city that works for you <br /> Advisory Commission Application <br /> Date 02 //0 /0?D/62_. <br /> General Information <br /> Name 2eItm L / hdq L , <br /> last First M.I. <br /> Address 3/p A'/0uJ4 4 U E . <br /> City, State ZIP A4 iD B R I G i- TO n/ , /Y1 A/ _S, -l I (2_ <br /> Phone 51-fn?,4, - 7/o O (p5l-1033 - 717 7 (n/ 8-5 s() <br /> Home Business Cell <br /> Email Address ) I z e.( vu C?o vv C a 5-f• ►n e+ <br /> LA) 2- &14-e.. ; W w w, 1,v do I z e I ►�,i , c.o vY) <br /> Commission/Task Force <br /> Public Safety Commission X Economic Development Commission <br /> X( Planning Commission Civil Service Commission <br /> Park,Recreation&Environmental Comm. <br /> Availability (Check all Preferences) <br /> X After work, early evening X Evening,after supper ){ Early morning <br /> List specific days or times you are not available ÷U E S CAA VYt"i d a ci U <br /> Personal Information <br /> List any related work/education experience: <br /> v) eavv1vYi (2rC iq I t`Rea 1 Es-rA--r-F <br /> 6 c.terjv- Qin e n-4-r . p rey\eur r -een 0r1 eo11e1e. <br /> 4 L1 e' r S 1 Y\ r e_+ � INACI v1 Q 2 E' r + <br /> ` ,n yi"B �} 11Gt r!Za4-‘v)s -t�' <br /> nn c c wi (A l,u Mac I So v) <br /> VA aNJ SC.LS SI rq± D+nS <br /> g <br />