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tLvp addftinnaIIIIet ifnwptit <br />What is your vow 9Pe role of this CommissionlCommitteclTask Farce? <br />C e'loiz— rO 114,P D TV- a M. W11 Lo S. 0 cryLx-, <br />.VIII MMMMIIIIIIIIIIIIIIIIIIIIII��� IIIIII IIMillllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll <br />Other Comments: (Include anyfurther information you would like the City Council to consider or <br />that you eel is relevant to the appointment you are seeking. You may also teach other materiaLs you <br />would like the Council to <br />1c, ci ra&a� 9&::r o t 410 <br />-Les k. U ELL:.? I V, Als;i ae,- 4L, <br />"?Laz,� 014U-C-1 M-I �= 2U--Q-3 4; L <br />L IF <br />Tennessen War is - Some of all the information that you are asked to provide is classified by State law as either private <br />or confidential. Private data is information that generally cannot be given to the public but can be given to the subject of <br />the data. Confidential data is information that generally cannot be given to either the public or the subject of the data. <br />The City of Roseville is collecting the information to determine qualifications to serve on a Citizen ,Advisory Commission. <br />You am not legally required to provide this information. However, if you do not supply the information, you may not sew <br />on a Citizen Advisory Commission. <br />Other persons or entitics authorized by law to receive this information are City Council members, staff, residents of <br />Roseville and interested others. <br />i understand: <br />• This Vplic tin is public inIormatiom <br />• I will be invited to an intender by the City Council fat may be audio or video upxL <br />• This apphcatipa may be at a public meeting. <br />Signatm of Applicant <br />QcmniWan 8ppl1cad4nAw Rev G73M <br />Doe of Applicadon <br />d V <br />r 4 <br />