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lt <br />2WEN HILLS <br />City Commission/Committee Application Form <br />Or apply online at http•//www cityofardenhills ore/FormCenter/Cencral-Forms-3/City- <br />CommisionCommittee-Application-Form-54 <br />Date: <br />General Information <br />I <br />Name: 6[ v <br />Last U <br />f <br />First M.I. <br />Address: 19l 0 INJI <br />City, State,ZIP: 0A Q ns j 1.( N E6051 <br />Phone Numbers: Home: bl;t — 340 ' 1 37 Work: <br />Fax: <br />i <br />Fax: <br />Email Address: <br />Committees <br />If you wish to be considered for more than one committee.please order in number of preference. <br />Communications Committee(Newsletter) <br />Parks,Trails,&Recreation(PTRC) <br />Economic Development Commission (EDC) <br />Planning Commission <br />Financial Planning and Analysis Committee(FPAC) <br />Special Interests <br />As the Council prioritizes its goals,it may create additional new committees or task forces from time to time. If you <br />have other specific areas or topics of interest please indicate those interests and we will retain your application for <br />future openings in those areas as new committees are created. <br />Other Interests <br />Personal Information <br />List your work experience. <br />Ci <br />tYl fiYu 5 • ?}YL- 2•S 1 j(L, U+/Q- IGIJt-,1/l FZOY17 <br />City Committee Application Form <br />61 ^e l U Page 1 of 2 <br />J 71