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<br />~." <br />,,,'t'~ <br />~^, ',' :rr <br />",,' "ervu.e <br />~ <br /> <br />CITY OF CENTERVILLE <br />APPLICATION FOR APPOINTMENT <br /> <br />Committee or Commission applying for: <br />NAME: r\tc,'6..t~:s. lh \~~~n <br />STREET ADDRESS: l.l.n'a '"T;,k.. kJ\.L <br />CITY: 1-\1\0 kL I ~y.,~", \l <br />TELEPHONE Home jp51~ Yt)")- 3(.;.80 <br /> <br />rc:on6;"() I~ D-e."....lopM-L1'\.. { JljhO"'l~ <br /> <br />/ tv\o..\;'\~~~ ~L <br />111\ Ll!>-l- fl.\,-<. N <br />,. <br /> <br />MN ZIP: SSb~B <br /> <br />Number of years a Centerville Resident <br /> <br />Work ~<;7- 7"~ - Q'-/4{) <br />Fax (051- 1CD~ - "~l <br /> <br />Are you presently serving on a City of Centerville Committee or Commission? ~ 0 <br /> <br />Which One? <br /> <br />Term <br /> <br />Have you served on a City of Centerville Committee or Commission in the past? ~ <br />Which One? ~c.>"'''''~V\ ~k... ~ Term <br /> <br />Which One? <br /> <br />Term <br /> <br />What do you have to offer to The City of Centerville Committee or Commission? _ <br /> <br />iO.-t- ~L.u:t Lc.........."'Y\.Lrc...:.J <br /> <br />k-~\ ~ 4->Gf-<-~'~CA- ~:t1 v,M':-\\A-<\" <br />€.n"'u'~~~ l~~, \~ ~\o~ I <br /> <br />. <br />~ ('[ ~u... ..JJo.I' 'LOr'\ \ ~ ' <br /> <br />"l'f"",,,..k -r- <:",,-k..j,~ ..( ^~~J <br /> <br />EXPERIENCE OR EDUCATION THAT WOULD ENHANCE YOUR EFFECTIVENESS <br />AS A COMMITTEE OR COMMISSION MEMBER <br /> <br />\0 +1tA.-S ~~~ J lltNJ 4~c... ~ "~~""'- lJrll~r!..6 <br /> <br />SIGNATUR~~ <br /> <br />--- <br /> <br />DATE 3/' 't J 07 <br /> <br />Return to: City of Centerville, 1880 Main Street, Centerville, MN. 55038 <br />