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W hat is vour view of the role of this CammissionlCommittee/Task Force? <br />Other Comments: (IncLude any further infonnc�tors you would like the City Council to consider or <br />tl2at you feel is relevant to the �ppointnz��xt you are seeking. You nuzy also attach other rnaterials you <br />would like the Courzcil to consider.) <br />Te��nessen Warning - Some or ail the ipfarntatzon that you are asked to provide is classified by State law as either private or <br />ca��fidenrial. Private data is infor�iation that generaily cannot be given to the public but can be given to :I = subject of the data. <br />Confidential data is information that generally cannot be given to either the public or the subject of Yhe data. <br />The City of Roseville is collecting the infonnation to deteinune 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 isafonnation, you may not serve on <br />a Citizen Advisory Con�nissi�n. <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 infonnation provided m tlus application, except my telephone numbers, fax i�tu�ll�er and <br />ez�aii address, may be c�is€t7btz�ed by the City to the public including but not limited to, being posted on flle <br />City of Roseville website. I agree to waive any and all claims under the Minnesota Gpveinmel�t 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 infonnation contained in '..�.i,� application that 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 i �4�a � of the information provided. <br />I understand that the City will not publish iny phone or fax numbers or eixzail address without my autl�oi�ization <br />and do hereby aitaw ti�e City to ��b1s'y (check all tl�at apply). <br />� I�,�k� telephone n�ber <br />�work teleplioz�e nu�lber <br />�hoi�le email address <br />,���.5: u� � email address <br />�- ' - �� r <br />�_� � <br />�.'� r"= <br />���irL M-�r_-- <br />� �itin:n�r e=f�F�<i <br />Applicntioii 050523 <br />� �� �� � ��.: �_ <br />Date of Application <br />