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What is your view of the role of this ommittee/ Faslc~'ee? ' % C S ~~ </ ,t L''7M I' iFl Cc (~(L ~ i' i 'G YZ C~ wL f~\ h%i-L e I~ vt~ . e_ ' .~ r: ~-~~ ' j, i > c\ t^z ~~z. Y`es :.. I "f' ~~' i. ~ ~ 1 ~ C. C-~,~_{~'t~. tt ~ l ~-}z,i ('• o t- i~i„~ 1 ~- D r-c:: ~ ~ ~~ / s , Other Comments: (Include u/rv f n4her informatiaa rnu ia~ould Irke the C/.l Cotn ell to co/tslder or shat you feel is relevant tr> the a/~poilitnteltt yowl a~e seeldlig. Yotr nlav also attach other materials rou would like the Counci! to consider.) __ Tennessen \Varning -Some or all the information that you are asked to provide is clas'si fled by State law as either private or confidential. Private data is' information that generally camiot be given to the public but can be given to the subject of the data. Confidential data i5 information that generally cannot be given to either the public or the subject of the data. The City of Roseville is collecting the information to detclmine qualifications to serve on a Citizen Advisory Commission. You are not legally required to provide this information. However, if you do not supply the information, you may not serve on a Citizen Advisory Commission. Other persons or entities authorized bylaw to receive this information are City Council members, staff, residents of Roseville and interested others. I mlderstand that all information provided in this application, except my telephone numbers, fax number and email address, may be distributed by the City to the public including, but not limited to, being posted on the City of Roseville website. I agree to waive any and all clauns under the Minnesota Government Data Practices Act, or any other applicable state and federal law, that in any way related to the dissemination to the public of information contained in this application that would be classified as private under such laws. I understand that I tray contact the responsible authority for the City ofRoseville ifI have any questions regarding the public or private nature of the information provided. I understand that the City will not publish my phone or fax numbers or email address without my authorization and do hereby allow the City to publish (check all that apply). -home telephone number -work telephone number -other telephone number home fax number -work fax number %lhome email address, -work email address - % , __ I " Signature of Appli ant Date of Application .1 pp/icmion 06! /lY