Laserfiche WebLink
~i~ <br />CITY OF NEW BRIGHTON <br />803 - 5TH AVENUE N. W. <br />NEW BRIGHTON, MN 55112 <br />IghtOn 633 - 1533 <br />APPLICATION FOR ADVISORY GROUPS <br />GROUP APPLIED FOR: //'' <br /> <br />SECOND CHOICE (IF ANY); <br />FULL NAME (PRINT OR TYPEr ): <br /> <br />ADDRESS: <br />J ~O©- / 9 ~ ~7, iv. (,{J /SAP GC> /,~2~Gi~~1~~ ni®v. S'S ~ ~ Z <br />YEARS ATTHIS ADDRESS: YEARS YOU HAVE LIVED IN NEW BRIGHTON: <br />,3 3~ <br />TELEPHONE: HOME: WORK OR OTHER: <br />X33-- 777 7 ~ 33-G~ioo <br />QUALIFICATIONS YOU WANT TO HAVE THE COUNCIL CONSIDER <br />EDUCATION: <br />~-2 -c v - ~ G/5' /~ <br />l~--GC~cI.-Ce-2y~ t9 ~.w ~ ~~G <br />vQ~'Lt ,ems ~jrYGC-~t.`uq,~~~ ~C a--+.--~¢.._~ ~- <br />EMPLOYMENT, OCCUPATION OR OTHER EXPERIENCE: <br />/`~'~f ry/ e /a2.2,(.t ~C-Clc>~ ~- ~ ~'7 icJ d l~ flo~ecQv/2/~ ~v i - 9~ l Psv~+2~ C.-o~t r°/~f9~" %C7~i <br />MEMBERSHIPS, ACCOMPLISHMENTS OR OTHER QUALIFICATIONS: <br />~(, I v-zc S <br />/~A 5 % IJ' ~ .a w w ~ w !r C ~w~ ~I c 5 c cr~.,~ <br />Pas ; ~ ~ cad / ~~t~,.« ~n~p s _ <br />#P-LEASE STATE YOUR REASONS FOR WANTING TO SERVE ON THIS COMMITTEE: /~ <br />1 ~/'/ U e /~ ~J' 7,¢ci-t lr ~ / 5 i o ~C~/ ! o ~'Q~ ~` E (. ~ c 7/ ~ ~ sv g ~-~~ ~J . ~. <br />~"` C ~ 2v' ~ %4 /DAQ ~- 7`~.n `T G[> crul~rl' -~ -~-~ ~c ~ 6~ `r ~~'c''~P ~`'' ~ <br />YOUR RESPONSE TO ANY OF THE ABOVE MAY BE CONTINUED ON THE BACK AND YOU MAY ATTACH ANY OTHER MATERIALS <br />WHICH YOU WANT THE COUNCIL TO CONSIDER. <br />SIGNATURE <br />DATE ~ ~ ~ ~/ <br />THE CITY OF <br />FACILITIES, ~ <br />RIGHTON IS COMMITTED TO THE POLICY THAT ALL PERSONS SHAD HAVE EQUAL ACCESS TO ITS PROGRAMS, <br />EMPLOYMENT WITHOUT REGARD TO RACE, CREED, COLOR, SEX, AGE, NATIONAL ORIGIN, OR HANDICAP <br />