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Attachment C <br />Sample Application <br />Name : _______________________________Date of Application: _____________________ <br />Address (no P.O. boxes please): _________________________________________________ <br />Email Address: _______________________________________________________________ <br />Phone Number: _______________________________________________________________ <br />Daytime Number Evening Number <br />School Grade during 2020-2021 School Year <br />Date of Birth _____/____/________ MM / DD / YYYY <br /> <br />The City of Roseville Commissions hold one regular meeting per month. As a member, your presence is <br />expected. More than three unexcused absences (without contacting the chair or staff liaison first) may <br />lead to you stepping off the commission. <br />Which Commission are you applying to?_______________________________________________ <br />Tell us what unique qualities, talents, and experiences you have that would benefit the <br />Commission:____________________________________________________________ <br />_____________________________________________________________________________ <br />_____________________________________________________________________________ <br />_____________________________________________________________________________ <br />_____________________________________________________________________________ <br />_____________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />Please list school and community activities or service organizations in which you are involved: <br />___________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />The Youth Commissioner's purpose is to discuss and advise the City Council on the needs and concerns <br />of youth. Please explain what you believe is the biggest issue affecting Roseville and how you would <br />address it. (You may attach a separate sheet with your answer.) ______________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br /> <br />