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, Hv;w ha,s�our },i;e�r �f kh� rul� vf tbis �'�m m�ssian �han�i sflnce �-�R�r first t�rrr� � <br />. . _....—_. . ,. . . .... .. .. __. <br />, � <br />� ' �� f/�� � t-a.�` ��� , ��� r � T�_.� ��� �� �•'_�� f� .—" <br />� � <br />Other Comments: (Include any further information you would like the City Council to consider or <br />t1�at you feel is relevant to re- appointment. You may also czttacl� other materials you would like the <br />Council to consider.� <br />��� �- <br />�_..� :� <br />� � <br />}� <br />�i.. �r� .r � �. _. �i_�_.�f.f:�� _._ <br />�� , � <br />..����-����:� ���� � •��:��}r��-� = <br />� r� 1��� � �" �,��� � ������,����i ����� _ �����.r �./'�`; . ���� <br />} C_ - � * � - � <br />��� �:�—�f.��`��� �. . ���.. _. �'� . �-'.-�•'•' ���`��� � ��" �' � . -- <br />.� � <br />Tennessen Warning - Some or all the infonnation that you are asked to provide is classified by State law as either private or <br />confidential. Private data is information that generally cannot be given to the public but can be given to the subj ect of the data. <br />Confidential data is information that generally cannot be given to either the public or the subj ect of the data. <br />The City of Roseville is collectingthe informationto determine qualifications to serve on a Citizen Advisory Commission. <br />You are not legally required to provide this information. However, if you do not supply the information, you may not serve on <br />a Citizen Advisory Commission. <br />Other persons or entities authorized by law to receive this information are City Council members, staff, residents of Roseville <br />and interested others. <br />I understand that all informationprovided in this application, except my telephone numbers, fax number and <br />e�ail address, may be distributedby the City to the public including, but not limited to, being posted on the <br />City of Roseville website. I agree to waive any and all claims under the Minnesota Government Data <br />Practices Act, or any other applicable state and federal law, that in any way related to the dissemination to the <br />public of information contained in this applicationthat would be classified as private under such laws. I <br />understand that I may contact the responsible authority for the City of Roseville if I have any questions <br />regarding the public or private nature of the information provided. <br />I understand that the City will not publish my phone or fax numbers or email address without my authorization <br />and do hereby allow the City to publish (check all that apply). <br />�home telephone number <br />work telephone number <br />home ezanail address <br />work email address <br />i <br />� � <br />�����„�-��� -.��-����-;���:.�-��� ..�.��'�r. .=� ..���'�� � <br />��� iir�l i�rt tti I� r���l iti;snl I�}�[t �}� r� �}�FI1C2kLLlf11 <br />ReappointmentApplication 0412 <br />