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<br />e <br /> <br />. <br /> <br />e <br /> <br />~ <br />~~HILLS <br /> <br />City Committee Application Form <br />Date "'{2b/O~ <br /> <br />General Information <br /> <br />Name <br /> <br />VI('i~O--. (G1~H.V <br />Fust <br />I~ 4FlII <br />~ls WIIJ 66112- <br />Home c'cSI-S03-'lOS)( <br />Fax <br />~r1Wil @flf~.Vler <br /> <br />ft. <br />M.l. <br /> <br />~~u.~on <br />Last <br />~iVlt. lVee <br /> <br />Address <br />City, State, ZIP <br />Phone Numbers <br /> <br />Work <br />Fax <br /> <br />(f.,3-S7l- 2.IOD <br />-'103 -51'2. -'113) <br /> <br />Email Address <br /> <br />Committees <br />I f you wish to be considered for more than one committee, please order in number of preference. <br /> <br />L Newsletter <br />Parks, Trails, & Recreation (pTRC) <br />City Events Task Force <br /> <br />Operations & Finance <br />Planning Commission <br /> <br />L Website Task Force <br /> <br />Soecial Interests <br />As Ihe Council prioritizes its goals, it may create additional/new committees or task forces from time to time. If you <br />have olher 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 /> <br />Other Interests <br /> <br />Personal Information <br /> <br />List your work experience. <br />, fYlo..vllehnq. Wtb~-itute~ VI, dIilq:} a zlne ~ubl'shevJ retan (!oVlsultiVl11 <br />~lIl, ete. See l.l:&ad!ed V'e~~. <br /> <br />City Committee Application Form <br /> <br />Page I of2 <br />