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Any further information you would like the City Council ta consider or that you feel is relevant to the appointrnent yau are seeking.: I am familar with the city having lived here for 39 years. I have the tim� availa�te to research issues and provide input: I would like ou�r city to con�inue its evolu�ion in a qualit� �ay. I understand that all infarmation provided in ihis applicaiion, except my telephor�e number, fax number and email address, may be c�istributed by the City to the public including, but not Iimited to, being posted on the City of Roseville website. I agree ta waive any and all claims 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 taws. I understand that I may contact the respon�ible authority for the City of l�oseville if I ha�e any questions regarding the pub�ic or private nature of the information provided.: Yes I undersEand that the City �vill not publisf� mq phone or fax numbers or email address without my anthorization and do h�reby alIow the City to publish (check all ihat apply).: Home telephone number Daytin�e Phone: Evening Phone: Cell �hone: i Home Phone (zf differen�}: Work Phone {if different): Home Fax: Work Fax: Home Email: � �� Wark Email: St�dent Appli�catior�; Na If yes, please list your grade: May we contact �ou using your wark email or fax?: Yes I have read and t�nderstand the stateanents an this form, and I hereby swear or affirm that the sCatem�nts on t��s form are true. : `Yes Addition.al Informatian: �'orm submi#ted on: 1/19/2009 5:20:Sq PM 5ubmitted from IP Ac�ciress: