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needs to become more desirable for a variety people regardless af their age range, income level, single/married, ethnicity, etc. I understand that all information prov�ded in this application, except my telephone numb�r, fax number and email address, may be distiributed by the City to the public including, but not limited to, bezng posted on the City of �oseville website. I agree to waive any and all claims undeY the Minnesota Government Data Practices Act, or any other applicable stat� and federal law, that in any way rela�ed to the disseminatian to the public of information contained in this application that would be classified as prYVate under such laws. I understand that I may contact Che res�onsible author�ty for the City of Roseville i� I have any quest�ons �egarding the public o� private nature of the information provided.: Yes I understand that the City wi11 not publish my phone or fax numbers or email address wi�hout my authorization and do hereby al�ow tihe City to publzsh (check all �hat apply).; not checked Da�tiirne Phone: Evening Phone: Cell Phone: Home Phone (if different): wo�k Phone (if different): Home Fax: work Fax: �ome �mail: Work Email: Student Applica�ion: No If yes, please List yaur grade: May we contact yau using your work email or fax?: No I have read and understand the statements on this form, and I hereby swear or affirm that the statements pn this fo�m are true. : Yes Additional Information: Form submitted on: 2./27/20Q5 8:36:03 1�M Submitted from �P Address: Form Address: http://mn-roseville.civicplus.com/forms.asp?FI�=237 2