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WhatisyourviewoftheroleofthisCommission/Board?:TheHumanRightsCommissionshouldshowcaseRosevilleasa <br />citythatiswelcomingtoall! <br />AnyfurtherinformationyouwouldliketheCityCounciltoconsiderorthatyoufeelisrelevanttotheappointmentor <br />reappointmentyouareseeking.: <br />IunderstandthatinformationprovidedinthisapplicationmaybedistributedbytheCitytothepublicincluding,butnot <br />limitedto,beingpostedontheCityofRosevillewebsite.IagreetowaiveanyandallclaimsundertheMinnesota <br />GovernmentDataPracticesAct,oranyotherapplicablestateandfederallaw,thatinanywayrelatedtothe <br />disseminationtothepublicofinformationcontainedinthisapplicationthatwouldbeclassifiedasprivateundersuch <br />laws.IunderstandthatImaycontacttheresponsibleauthorityfortheCityofRosevilleifIhaveanyquestionsregarding <br />thepublicorprivatenatureoftheinformationprovided.:Yes <br />OccasionallyCitystaffgetsrequestsfromthemediaorfromthepublicforwaystocontactCommissionmembers.The <br />Commissionrosterisperiodicalymadeavailable.PleaseindicatewhichinformationtheCitymayreleasetosomeone <br />whorequestsitorthatmaybeincludedontheCommissionroster.UnderMNStatute§12.601.subd.3(b),eithera <br />telephoneorelectronicmailaddress(orboth)whereyoucanbereachedmustbemadeavailabletothepublic.Please <br />indicateatleastonephonenumberoroneemailaddresstobeavailabletothepublic,andfillinthecorresponding <br />informationinthebelow.:CellPhoneNumber,PreferredEmailAddress <br />HomePhone: <br />WorkPhone: <br />CellPhone: <br />PreferredEmailAddress: <br />Ihavereadandunderstandthestatementsonthisform,andIherebyswearoraffirmthatthestatementsonthisform <br />aretrue.:Yes <br />AdditionalInformation: <br />Formsubmittedon:10/7/201210:22:45PM <br />2 <br /> <br />