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<br />(i.. <br /> <br />CRY OF CEN1ERVLLE <br />APPLICATION FOR APPOINIMENT <br /> <br />Co,..mIIII. at CaInnUIIcn 8PPIYQI for. ... & RV'<-~n CalMlIlIM <br />HAlE: M8IIc*dH <br />DII'CI:I!T ADDRESS; ..1......PDndWly <br /> <br />CITY: ~ <br />TaEPHONE Hame 1151-782<<193 <br /> <br />UN ZIP:" "17 <br />Work 8B1..wr..a28 <br /> <br />fUnbw or,--. c.lIMIIIlIe Rullllnt <br /> <br />3 <br /> <br />Fee <br /> <br />1ft ~ pN.I lII) ...... an 8 C/lJ or CetdIrvUIe Coml.lI" .1 at C4l..i IJ "lln? No <br /> <br />'t.IlIdI Onet <br /> <br />Term <br /> <br />.... ~ __ an 8 CIly tI ~118 CammIltu or ComJlllnlX\ In" pall? No <br /> <br />WhIch OM? <br />\\tIIeh One? <br /> <br />Term <br />T.... <br /> <br />WhBl do yQU...1o dI'Ilrto The CIly of Cell." eo........or COhllillnlM? <br />IcualkmramUnd .1....... J . ;~...Ihe....&~lIaIIc......n._ _...-mlD...~dIl.. <br /> <br />. ~" placIlD ....and....... <br /> <br />DPERENCE OR EDUCATION ntATWOUI,D BIWICE YOUR EFFECTM!tE88 <br />AS,. COIilblld! OR comtI88.1ON I8f8ER <br /> <br />E.b......u...................~ dalII and maIIaIIlllllllMlih.. ~. rdwaflllll""lcIlaaI cIIlIcIran <br /> <br />... pnIllldrt ll1I.pIlIntr IIf tlllll.......1n IndaclrInd auldaor '~h' <br /> <br />8KJNAlVRE ~~ <br /> <br />aA1E 0112210I <br /> <br />......... to: CIly olc..-m_ 1880......... 011... .. MN. !a038 <br /> <br />-31- <br />