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<br />~.'_urujf( CITY OF CENTERVllLE <br />,~:":'.~ APPLICATION FOR APPOINTMENT <br /> <br />Committee or Commission applying for: ? 0-\ \(. 4- ~ <br />~ARA fE~R.l=-W~Ac..\+E ~ <br /> <br />NAME: <br />STREET ADDRESS: 13:S 0 P E.L ""\\ E ~ <br />C.Sl0'\E..(l..\J l LL~ <br /> <br />C-.\ R.U-G <br /> <br />CITY: <br />TELEPHONE Home (p-r; \ 7 ~ 4 <br /> <br />Number of years a Centerville Resident <br /> <br />Are you presently serving on a City of Centerville Committee or Commission? <br /> <br />}J 1A- Term (V fA <br /> <br />Which One? <br /> <br />Have you served on a City of Centerville Committee or Commission in the past? <br /> <br />U(A <br /> <br />~IA <br /> <br />Ub <br /> <br />bl}A <br />t0/A <br /> <br />Which One? <br /> <br />Tenn <br /> <br />Which One? <br /> <br />Tenn <br /> <br />What do you have to offer to The City of Centerville Committee or Commission? <br /> <br />~:;~~~~~;~~ <br /> <br />C-- ~ ~ c:....,..V' "":"PP (j -< .l<: t'N~ u <br /> <br />EXPERIENCE OR EDUCATION THAT WOULD ENHANCE YOUR EFFECTIVENESS <br />AS A COMMITTEE OR COMMISSION MEMBER <br />~;><:P~~VL'-'L~~~ ~l ~P.:. ~ ~- <br />~ ~U~"-"'-'--"- ~\~ <br /> <br /> <br />SIGNATURE~~ <br /> <br />DATE g --C;; -6+ <br /> <br />Return to: City of Centerville. 1880 Main Street. Centerville. MN 55038 <br />