Laserfiche WebLink
• -- • -- ._....__ �._._._ --- --- -- ---- - - - <br />�4`h�� i.� kaui�;��ti� af �he role of' a member of the lluusin4 S, Rec�evelupment .�u���rit+��� <br />Other Comments: (Include a7xy further inforraaa�ian you would like the Mayo� and City Council to <br />conside� o� that you feel is �elevant to the appointment you are seerting. You n2ay also attach othe� <br />mate�ials vou would like conside�ed. ) <br />Tennessen Warning - Some or all t�e information tl�atyou are asked to provide is classified by Slate law as either private <br />or confidential. Private data is information that generally cannotbe given to the public but can be given to the subject of <br />the data. Confidential data is information tl�at generally cannotbe given to either the public or the subject of the data. <br />The City of Roseville is collecting the information to de�ennine qualifications to sez�ve 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 <br />on a Citizen Advisory Commission. <br />Other persons or entities authorized by law to receive t��s information are City Council men�bers, staff, residents of <br />Roseville, and interested others. <br />I understand 1ha�: all �iz�for��alio� provided in this application, except my telephonenurnb�r�, fax number <br />and emai�i address, may be distributed by the City to the public including, but not limited to, being posted <br />on the City of Roseville r�v�bsite. I agree to waive any and all claians under the Minnesota Govern�ner�t <br />Data Practices Act, or any other applicable state and federal law, that in any way related to the <br />dissexni.�,at�o�. to the public of information contained in this application that would be classified as private <br />under such laws. I understand that I�nay contact the responsible authority for the City of Roseville if I <br />have any questions 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 ��aal address without my <br />authorization and do hereby allow the City to publish (check all that apply). <br />_ home telephone number <br />� home e�x�a�l address <br />,� wozk telephonenumber <br />���n�i��sk�:�d iha n:�:r bc i:�k�i k�� l� an :�tit�r�: i, �� b�� lhe �i�� �,��c� I il �t �nay be audio or videotaped. <br />�i�L�r� {af �-rl i�.�n — ---- <br />Updated: (}9104 <br />��'�, 7 � �� �� <br />Date of r����Ji��ti oi� <br />