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2021_0125_CCPacket
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2021_0125_CCPacket
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1/13/2022 1:40:37 PM
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1/13/2022 1:40:18 PM
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Roseville City Council
Document Type
Council Agenda/Packets
Meeting Date
1/25/2021
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Attachment B <br />1.This application is for Roseville residents interested in volunteering with a City of Roseville <br />Advisory Commission. <br />In order to complete this application, you will need a valid email address. All items marked <br />with a star (*) are required fields. <br />2.ContactInformation <br />Under state statute, commissioner's names, addresses and either a phone number or an <br />electronic address where you can be reached are public information. All other personal <br />information is private data and cannot be released to the public unless the commissioner <br />gives permission for the city to release it. Information relating to a student representative is <br />private data and will not be released. <br />3. First Name* <br />4. Last Name* <br />5.Address 1* <br />6. Address 2 <br />7. City <br />Roseville <br />8. State* <br />MN <br />9. Zip Code* <br />55113 <br />10. Home or Cell Phone Number* <br />11. Email Address* <br />12. How many years have you been a Roseville resident?* <br />13. City of Roseville Commissions <br />Finance <br />Human Rights, Inclusion and Engagement <br />Parks and Recreation <br />Planning <br />Police Civil Service <br />Public Works, Environment and Transportation <br />14. Commission preference* <br /> <br />1st Choice <br />15. Commission preference <br /> <br />2nd Choice <br /> <br />
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