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0 IP <br />What is your wew of the role, of this Commission/Committee/Task Force? <br />" A44 4L" <br />1"4 <br />AF 1 17, <br />Other Comments: (Inc"lude anyfurthek in <br />,rormation you w <br />that youfeel is relevant to the appointment you are seeking. <br />woy,M,� like tie <br />' You may also attach other materialg you <br />G= <br />Tennessen Warning - Some or all the infon-nation that you are asked to provide. is classified by State law as either private or <br />confidential. Private data is information that generally cannot be given to the public but can be given to the subject of the data. <br />Confidential data is infonnation that generally cannot be given to either the public oT the subject of the data. <br />The City of Roseville is collecting the information to determine qua Iffications to serve on a Citizen Advisory CoD=on. <br />You are not legally required to provide this information. However, if -you do not supply the information, you may not serve on <br />a Citizen Advisory Commission. <br />Other persons or entities authorized by law to receive this infonnation are City Council members, staff, residents of Rosevi <br />and haterested otbeTs. i <br />I understand that the City will not publish my phone or fax numbers or email address without nay authorization <br />and do hereby allow the City to publish (check all that �pply). <br />home telephone numb <br />work telephone numb <br />home email address <br />work mail address I <br />Signature of Applicant <br />Application 1 60621 <br />