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<br /> <br />plQcJ. ~ <br /> <br />OM U::1eYlS <br /> <br /> <br />Other Comments: (Include any further iriformation you would like the City Council to consider or <br />that you feel is relevant to the appointment you are seeking. You may also attach other materials you <br />would like the Council to consider.) <br /> <br />Tennessen Warning - Some or 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 infom1ation that generally cannot be given to either the public or the subject of the data. <br /> <br />The City of Roseville is collecting the information to determine qualifications to serve on a Citizen Advisory Commission. <br />You are not legally required to provide this information. However, if you do not supply the information, you may not serve <br />on a Citizen Advisory Commission. <br /> <br />Other persons or entities authorized by law to receive this information are City Council members, staff, residents of <br />Roseville, and interested others. <br /> <br /> <br />I understand: <br />. This application is public information. <br />. I may be invited to an interview by the City Council that may be audio or video taped. <br />. This application may be discussed at a public meeting. <br /> <br />~J~/JJ1~ <br /> <br />Signature of Applicant <br /> <br />7/2'1/0 2- <br /> <br />Date of Application <br />