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� ��•���� 11�11�� � � ' ' r�_���} <br />�•,�, .I � <br />www.ci.rosevill�.m n. us <br />City of Roseville . 2��60 Civic Center Drive . Roseville MN 55113 <br />Phone: 651.792.7001 . Fax: 651.792.703� <br />Application for Citizen Advisory Commission <br />Please check s�:=,�:,�;;}�ti�;: �� applyingfor: <br />EI Grass Lakes Water Management Organization <br />❑ Human Rights Commission <br />� Park and Recreation Commission <br />� Planning Commission <br />0 Police Civil Service Commission <br />p Public Works, Environment and Transportation Commission <br />❑ Community Com�nrtteelTas� Force (���7�} <br />� r � <br />Name•_ _ ��[r,+'� ��•¢���� � <br />�y ,� <br />City/State/ZiP�_. f�r�. � L'r_ [��.. ��� ����✓����_�_ <br />Work Experience: _ <br />� , „ <br />.. _ , .:. ! � - ..� � --- �— - — <br />E d ��c�ttnr� � - � .. � _ . .� - -- <br />�f .{ _. _ ft }�� + —._ . ._ . � <br />- '_' ' " �f ��� �� r..{r-rY ]�-rti __ <br />. .-. - ���� . <br />� '\ 1 .. .. C �}���� '� — <br />.._ . � <br />r - <br />r �•+t _ ,x y� { <br />�.. � __.. ..,.. � � �,�I.�_ <br />f ���� � <br />. _. -�a � ��r�r � <br />_Civic and Volunteer Activities: (Past crrzd Preserzt� _ '�' ' - �•� r" �1�.��: _ <br />._ _ ,.. � <br />Please state your reasons for wanting to serve on the CommissionlCommittee/Task Force: <br />(Be as specific crs pa,ssible - use r�dctitia�icrl sheet if rzecessa�ry) <br />