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<br />~;;;7:!H~ APPLI~~g~ ~~~~~~~T~~MENT <br />Committee or Commission applying for: -P c\ '( ~ "\ V_E' C , me vn bey <br /> <br />NAME: ~SCI\jnnn(,{h LH <br />STREET ADDRESS: ili Gl R r I Ct n D r: <br />(~vl+-CV I/illf <br />TELEPHONE Home ldS I 120 I Z"'5.q Work - <br />Number of years a Centerville Resident t"V\ O~ u r3 Fax.~ <br />U <br />Are you presently serving on a City of Centerville Committee or Commission? <br /> <br />CITY: <br /> <br />MN <br /> <br />ZIP: <br /> <br />5So?;R <br /> <br />NO <br /> <br />Which One? <br /> <br />Term <br /> <br />Have you served on a City of Centerville Committee or Commission in the past? ~ <br /> <br />Which One? <br /> <br />---------.--- -. <br /> <br />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 />-A- (jOl )fOB EV! +' rP:sh ()p ;'ri 10 n ~rs~cHve~ <br /> <br />EXPERIENCE OR EDUCATION THAT WOULD ENHANCE YOUR EFFECTIVENESS <br />AS A COMMITIEE OR COMMISSION MEMBER <br />3 tr) (\::-- -\- 12€c rnPe+rrCjc,) dad 13 -red+- c)~ <br />Clr-l~ Cn,lnr('ff( ) WO(\Cp(j on -fQn::uip fOv_2<:jeoo' <br />ClennNj parts avd plan+-ed 1YPPS on t:-aJf-/7 TAr. (" <br />~~\ ^ d~1 <br />SIGNATURE \~JJ~()OYYU:J...) ~c DATE / --28- 0 8 <br /> <br />Return to: City of Centerville, 1880 Main Street, Centerville, MN 55038 <br /> <br />-30- <br />