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PleasestateyourreasonsforwantingtoserveontheCommission/Board::CivicengagementtobenefitRoseville. <br />WhatisyourviewoftheroleofthisCommission/Board?:Theplanningcommissionservesaprincipleroleinthe <br />functioningandoperationofourgreatcity.TheplanningcommissionistheconduitandinterfacebetweenCity <br />GovernmentandCitizenswithkeyinvolvementintheprogressandstrategicbettermenttothequalityoflifefor <br />residents. <br />AnyfurtherinformationyouwouldliketheCityCounciltoconsiderorthatyoufeelisrelevanttotheappointmentor <br />reappointmentyouareseeking.:IthanktheCityCouncilforconsideringmyapplicationandhopetoservemy <br />communityandRosevilleneighbors. <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 />tsitorthatmaybeincludedontheCommissionroster.UnderMNStatute§13.601.subd.3(b),eithera <br />whoreques <br />telephoneorelectronicmailaddress(orboth)whereyoucanbereachedmustbemadeavailabletothepublic.Please <br />indicateatleastonephonenumberoroneemailaddresstobeavailabletothepublic,andfillinthecorresponding <br />informationinthebelow.:PreferredEmailAddress <br />HomePhone: <br />WorkPhone: <br />CellPhone: <br />PreferredEmailAddress: <br />Ihavereadandunderstandthestatementsonthisform,andIherebyswearoraffirmthatthestatementsonthisform <br />aretrue.:Yes <br />AdditionalInformation: <br />Formsubmittedon:2/28/201312:15:57PM <br />2 <br /> <br />