Laserfiche WebLink
Cttennile CITY �OF CENTERVILLE <br /> �gkll APPLICATION FOR.APIK.)INTMIEN'T <br /> applIlYing for: ..........................f........................(:�-—------ <br /> NAI%ffi� <br /> STREETADDRESS: <br /> CITY kerVWp,--, MN ZIP CODIII",�� <br /> ............ <br /> I 110ME TE1,E'TI,110NE: WORK TEIEPHONE� <br /> FAX EMAIL.A.11DUR 'IS S: Ir .. . .........cj !I I,,() I In <br /> Giwnee?: <br /> Are yo,,.ni j1presently s'airving on a (.'aiat;;rvi ll ICIonl.mfttee or <br /> Which One?: Tle=?, <br /> I la,ve you sfavv,tA a Ceuill,-erville, Ir."kaurliftce ('11MMITRISS1101111 llln the past? .............. <br /> Which One?: Term? <br /> Whidh One?:: I`erni?: <br /> What do you have to anr the Cit3� of' Centerville �as �a Carnmittele or Comr-nisslolill. <br /> mern beil: L, <br /> UL L6 L 1 <br /> r. <br /> kt <br /> ta <br /> k''IAPM <br /> D C, <br /> Ex,,11plerience ()r E(11111C altil'0111 that wir.yiihl euhairi:�:;e you'lir efft.,x;tilveness as a Commaittee or <br /> ICIDY'arnissilir.Yn rri.ember',: <br /> ............... <br /> Signature: <br /> �� ........... aim'a DaW� lll�l........... N, <br /> ............... <br /> Retum to: <br /> City Administraitor <br /> City of Centervi Ile <br /> 1880 Main Street <br /> Cerntrerville, M.N 55038 <br />