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� 11t2�/2010 13:T8 7637920209 7637920289 PAGE @2 <br />� ��� <br />EN �IIL�I,S <br />� <br />Cxty Comn��ssion/Cornnaittee Applicatian Far�n <br />�a� 24 .�1I0 <br />General Information <br />Name <br />Last <br />Firsi <br />M.I. <br />Address _ <br />City, State, ZIP �I�D�J� I t�S �,_��'?t�L�� <br />Phone Numbers Home . � �'_ Woz� _ _ <br />Fa� � Fax <br />Email Address _� I•�i� �G'�A�c.� , n+� <br />Committees <br />Tf you wish ta be coasiderod foT more than one committee, pleasc order in number of. preference. <br />Cobnmvnications Cotnmittee (Newstetter) <br />✓ Parks, Trails, & Recreation (PTRCj <br />Economie Development Cornlxazsszon (�bC) <br />Planning Comnnission <br />Fivancial Plaz�,ning and �.nalyszs �ommittee (FPAC) <br />Snec�al Interests <br />AS the Councii prioritizcs ita goals, it may create additional/new committoes or task forces from time to time, Tf you <br />have �ther epecific azeas or tvpiCs of interesi pfeasa indicaiC tho6e interestc and wc will recain your application for <br />future opcuings i.r chose areas as new committees are created. <br />Other T�terests <br />Personal �n�ox-mation <br />Ltst youX vt�xk ex�erience. <br />.. � . <br />� � f •- - � ' r � + <br />� / � � i 1 % . . . � � • • 1 �. r��i.' � • � • i <br />♦ • / L . � J � � � � <br />� City Com►nittee Applicatioa Form Page I of 2 <br />