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Please state your view of the role of the City Council: Other Comments: (Includeanyfurther informationyou would like the City Council to consideror thatyoufeel is relevant to the appointmentyou are seeking. You may also attach other materialsyou would like the Council to consider.a Tennessen Warning - Some or all the informationthat you are asked to provide is classifiedby State law as eitherprivate or confidential. Private data is information that generally cannotbe given to the public but can be given to the subject of the data. Confidential data is information that generally cannotbe given to either the public or the subject of the data. The City of Roseville is collecting the information to determine qualifications to serve on the City Council. You are not legally required to provide this information. Other persons or entities authorized by law to receive this information are City Council members, staff, residents of Roseville and interested others. I understand that all information provided in this application, except my telephone numbers, fax number and email address, may be distributedby the City to the public including, but not limitedto, being posted on the City of Roseville website. I agree to waive any and all claims under the Minnesota Government Data Practices Act, or any other applicable state and federal law, that in any way related to the disseminationto the public of information containedin this applicationthat wouldbe classified as private under such laws. I understand that I may contact the responsible authority for the City of Roseville if I have any questions regarding the public or private nature of the informationprovided. I understand that the City will not publish my phone or fax numbers or email address without my authorization and do hereby allow the City to publish (check all that apply). h o m e telephone number w o r k telephone number email address Signature of Applicant Date of Application Application040101 a