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k.206&-I-Vw -my V FEB M <br />4w9E% <br />% %ter %v ci. rose vil1e. inn. �� <br />City ofRose %,Hle s 2660 Civic Center Drive -* Roseville KN 55113 <br />Phone: 65 1.490.2206 * Fax: 65 1.490.2276 <br />Application for Citizen Advisory Commission <br />Please check commission applying for: <br />o Grass Lakes Water Management Organization <br />a Human lights Commission <br />a Farb and Recreation Commission <br />UrPlanningCommission <br />a Police Civil Service Commission <br />a Public Works and Transportation Commission <br />0 COmmunity Committeeffmk F nrce(n ate) <br />sm Student a No <br />Applicant a Yes, Grade <br />Address: ZgtS QjL*&0,eIr _5 , C+ - <br />�3 e c� r L No � �� 3 Roseville CEty /Statel7ip: 1� ��_ Resident � years <br />Telephone: (Home (Work) .51. 49 7 '4 <br />Email:_r_c1M baL+C- OC � _ Fax:. ��j � • ��� � <br />Work Experience: - -- <br />Educatlun <br />Civic and Volunteer Activities: (Past and Present) <br />Q-C� aA*106�� <br />