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I�iFk�' �1�1� 4111J�' S jt�5k'al� tllL' �:[F�4 t�t ��lE� �..i.�11�1111b�1�.�11. �'fI.I�I�C�� IEk{'{' 3��i�� dieki ��•1'ql��_' . - -- � .. .4��— � ��'3C�_�'��• � 4.�5 ��k� �� 4 �� . — r.�� +'� i c�._ � _.. '� ��L�}s � ';��t`= • � E.4}1�. -- Cs t }' � � � , ' _ , �� ' � '�. �'�- � k i f. -- . f�•• F�L J� Lf'r'+J �'L� C r� r�'�� 4� �t �+'�.f�. f_�! Y��'? � F�r.��.}�•.L .��R�� __ � f .� � Other Comments: (Include c��2y fu�the� rr� r� r;-r; �.•rr �r,rr you lvoulcl lilze �; ;'r:� City Council to co�zsicler o�� ��crr you feel is Yelevaf�.t to r^e- appoi��t�nei7t. You may also attaclz otlier mc�terials you would ��k� tlie �'i'Ji i�ll'i i !� r �'�,1! 5'i ?�r'r.� — . J ��_..��}'�'�J�f'L 1 �`.f ��l .�'. k� � '��_ f i �_ � U;�.'* f � fi �� _�? Lt�� — � � .�, , t. � •� ' .��. 4��.+�'�R �- i� 1,�� i� �� 5.-�!�}� � _ �'��'L � �k' '`r�.d�,�.��. ��;'� 1 �_�____ �k��..�:�.�'?_�� . ..r,? . .� � �� _ . � �� ' � _. �� t �� C ��-`J:*�}�� '� �. �� � � � � , Tennessen Warning - Some or all the information that you are asked to provide is classified by State law as either private or confidential. Private data is information that generally cannot be given to the public but can be given to the subject of the data. Confidential data is information that generally cannot be given to either the public or the subject of the data. The City of Roseville is collecting the in£oz-matio�� to detez-naine qualifications to serve on a Citizen Advisory Coi�unission. You are not legally required to provide tlus information. However, if you do not supply the information, you may not serve on a Citizen Advisory Commission. Other persons or enrities authorized by law to receive tlus uifonnation are City Council members, staff, residents of Roseville and interested others. I uilderstand that all u7foilnation provided in this application, except m r' telephone ntunbers, fax nunlber and eznail address, inay be distributedby tlie City to il i� public including, but not lii�.�ted to, being posted on tlae City of Roseville website. I agree to waive any and all claims under the Minnesota Govenvnent Data Practices Act, or any other applicable state and federal law, tliat in any way related to tlie disseminationto tlie public of infol�l�ation contained in tlus application tliat would be classified as private under such laws. I understand tliat 1 may contact the responsibie autlloi-ity for tlie City of Roseville if I have any questions regarding the ��i il ; I i� or private nature of tl�e inforn�ation provided. I understaz�d that the City will not publish my phone or fax nui�lbers or e�l�ail adciress without my authorization and do hereby allow the City to pnblish (check all tliat apply). . I � ;� n, , - telephone iluinber �c7-k telephonenumber hon�e en�azl address � �tiir; �ii:riil _ultil:t�_•� � �� — ;�n_�� i i�ca f �fli�.�u ii R�w�',�,.'o�c,ncnr :�y�.�knixw �a!� � � .� atc a�� xpl�ca�ic��s