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<br />I <br /> <br />k', l~ <br /> <br />CITY OF CENTERVILLE <br />APPLICATION FOR APPOINTMENT <br />Committee or Commission applying for: P ~fJ.bJ / i\J. G <I z.. 0 Ai /1\1 G- <br />NAME: JE c:;.S E LA~l G.~ <br />STREET ADDRESS: -,:5 6:; PE:LT J {;;"/J... CJJ R.. e...L.../C <br />CrN: e_~Nrli=R..vll j ~ MN ZIP: S-SO"'3g <br />TELEPHONE Homea;:S-l)" '-I v s-t./ 6 ~ Work ~U :::20$? -6~AO <br />Number of years a Centerville Resident CO Fax (~S J) 94(; - L/ J> 7 <br />Are you prese~ serving on a City of Centerville Committee or Commission? N C> <br />Which aJe? Term <br /> <br /> <br />Have you served on a City of Centerville Committee or Commission in the past? N~ <br /> <br />Which One? <br /> <br />Term <br /> <br />Which One? <br /> <br />Term <br /> <br />\Nhat do you have to offer to The City of Centerville Committee or Commission? <br />I PLA.t-.:) 0t.0 f\l\Akll~ (E"f\Jrf!"~..i.lIL 1 e I\A~ J::>E1.MA~floW....e:-. <br />1 wotJu/\ L.JkP--YO l<F ~ ACTIve- /10 J1/lYe.DJIVlJ'VlVNJN. <br />/1 Af'\'\ VFIL...) (;.001) A, KlJiOJO/Ar_ ;:>/t()~c..\j '1~f) 1>~AUIU&- <br />c.vM'"H- t>~t~LE)v\ \: AS- 'T~I AR..~.(F.. <br />EXPERIENCE OR EDUCATION THAT WOULD ENHANCE YOUR EFFECTIVENESS <br />AS A COMMITTEE OR COMMISSION MEMBER <br />I J-lA\JfF ~""-.) IN (' bOStVtur:nt)A)~~ 0JE.R.. i ~ y~. / AM- A. L lY #\L. <br />e..at)'rr~~ uvl-k:> t/A '" j)o~~ M OLTI Pi ~ ..p~~ ~ES tl)el..:Jr]AslCPI'1~ <br />ALL(!iVe'LINr.lj~K)(:..A'VLAtV!11J ~u_L..e-..J i iZA.UEL/KJ6- k <br />.fbJj't1~A""-'-'-rv/)~~ c..oUS\W~T'<WJ ~A~~. <br />SIGNATURE ~~~~..,/ DATE //~/-oB <br />Retum to: City of Centsrville~ ~Main Street, Centerville, MN 55038 <br />