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<br />~ <br />~HILLS <br /> <br />City Committee Application Form <br />Date))H ,:}R; 700 L <br /> <br />General Information <br /> <br />Name <br /> <br />S'tO DoLfi <br />Last <br />~~ra~~S . Lf):t ~:,;~ <br /> <br />Home &9-633--/J9d Work <br />Fax Fax <br />,..\0/11 S,'r-U1>OLI/- @ ffc)dl"'ty,~ft <br /> <br />:\ah.Q_F <br />First <br /> <br />:J <br />M..l. <br /> <br />Address <br /> <br />City, State, ZIP <br />Phone Numbers <br /> <br />Email Address <br /> <br />Committees <br />If you wish to be considered fur more than one committee,. please order in numller of prefureru:e. <br /> <br />Communications Committee (Newsletter) <br />Parks, Trails, & Recreation (pTRC) <br />Economic Development Commission <br />-X- PlAnning Commission <br /> <br />~eciaJ Interests <br />As the Council prioritizes its goals. it may creale addilional!:new committees or Illsk furees lrom lime to lime. If you <br />have other specific llJ:eaS octopi"" ofinrerestplease indicate those interesIs and we will remm yo.... application for <br />future openings in those areas as new commiuees are created. <br /> <br />Other Interests <br /> <br />Persomd Information <br /> <br />List YOll!."" work experience. <br /> <br />.27 ~~rs ~e ~I/s fi,'rb - IJIJ!lLde;.T l)(jn~S )'n <br />\) a fI lJil c.., p~<j I it IJ f) 5:. (;,...e-f r ..RSIA m..e tJlltJ U:..ed <br /> <br />City Committee Application Form <br /> <br />Page t of2 <br />