2004_0120_Packet - Laserfiche WebLink

Home

Pleasestate your view ofthe role ofthe City Council: �{ Other Comments: �lnclucle any further infot��ncdion you would like 1he Ci .ty Council�r� consider or +�u�' }xwrfeel t� relev�t to theappoiniment you are seeldng. You may also attach ot/ter materialsyou wuuld like a,[�� Council �� consider. ) � � l'ennessen Warning - Some or all the informationiFtat you arc asked to provide is � lassified by Statc law as either privatc or confidential. Piivat4 data is inFornlation that g�neially caitiiot be given to the public but can kt• giv�n a> �l�e �ubjcwt ti�l die d.iw. Cunficiential data is information that generally cannotbe given to eitherthc public or thc subjec[ of thc data. The City of Roseville is collecting the infonnation to determine qualificationsto serve on thc City Council. You arc not Icbully required to provide this information. Other p��uns or entiticy authori2o�16y law to re�civ� this information are City Council membcrs, staFf, �r�ident� of Kosr�•il�c and interesteci othcrs. ] understandthat a11 information provided in this application, exceptmy telephone numbers, fax number and emai 1 address, may be di stributed by the City to the public including but not limited to, being posted on the City of Roseville websi te. 1 agree � waive any and all claims under the Mimlesota Government Uata Practices Act, or any other applicable state and federallaw, that in any way related to the disseminationto the public of inforctiation c;ontaineci m this applicationthat would be classified as private under such laws. I understand that I may contact the responsible authority for the City of Roseville if l ha�e any questions re�ard'uig the public or private nature of'tt�e information provided I understand that the City will not publish my phone or fax numbera or emai 1 address without my authorization and do hereby allow the City to publish (check all that apply). —home telephone number work telephone number �.emaii address --� . .. -� --� -- �-� � � � �� - � � ��na ppLi�t Date of Application �'1 utiw U,Ur��,.