Laserfiche WebLink
<br />~--- -_. ---- --.-- -.-- --~._-~-~~ <br /> <br /> <br />~ <br /> <br />.. <br /> <br />~ VVl. <br /> <br />L2.. _._ CIlY OF CENTERVlllE <br />~ APPLICATION FOR APPOINTMENT <br />Committee or Commission applying for: _p~ aM ~ /l. iA' J <br />NAME: ffl~ qa Ju>-/WV <br />STREET ADDRESS: If) 9 7} /3l7 J ON 1Jh). <br />CITY:1J;J11)Avi Ill) <br />TELEPHONE Home f#I)J II/) -::J- R/(l/-<j <br />Number of years a Centerville ResidentJ 5 <br /> <br />Comiuilw <br /> <br />MN ZIP: .')5fJ38 <br />Work II) C)/ ;;)1 f~ __E.) J\ 14 <br /> <br />Fax <br /> <br />Ate you presently serving on a City of Centerville Committee or Commission? () 0 <br /> <br />Which One? <br /> <br />Tenn <br /> <br />Have you served on a City at Centerville Committee or Commission in the past? () () <br /> <br />Whim One? <br /> <br />Tenn <br /> <br />Which One? <br /> <br />Tenn <br /> <br />\Nhat do you have to offer to The City of Centerville Committee or Commission? <br />\J 1Ilf'JJd) Oj~ 1/h&f)tMlj(fliJ L ~ J /JlYlj //d) ,Q/li'JZ!O <br />,-Jili PLW1r) /J Ild 0 t II viJJj/J +1M t ~J;1ilA)}i # j 1/ (~JJ. <br />CiLyP}WIJIJ. j rdJ PiN; cI-d liJJ.WLLtl Ur.) 'fJA J tAl) paM (j /1# ARh <br />a..lJrnf)'lat~ll/)f (l/JJY1J111:iffYIplli~ (}IJ fJ/] 0f1;>~ <br />~E~ 0 ATION THAT 'OULD ENHANCE YOUR EFFECTIVENESS <br />AS A CQMMITIEE OR COMMISSION MEMBER <br /> <br />SIGNATURE ~ ~ DATE J/d if nUl. <br />Return to: City of Centervilla, 1880 Main Street, Centervills, MN. 55038 <br /> <br />/:2' <br />