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2004_0120_Packet
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2004_0120_Packet
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� <br />Please state your view of the role of the City Council: <br />��� �- - � . <br />Other Comments: (li�cla�de any fc�rther i�rforniatto�r Vot� would like the City Cott►tciC to consider or <br />lhat youfeel is �•�i��¢r�d to the appointmerit X�ait are seeking. Yfnr a�i�i ti' also attuclt other ntateriuls yott <br />ira�ri�� like r��r Coiu�cil �� consider.) <br />- --- - - • ----- •-- - . � . . . . . .. _ _ . . . .. . _ . . --- <br />��'�� �.���'�� -- ----•—• -•• - -�----.. _..- -- � <br />'Tennessen Warning - Some or all the infarmation that you are asked to provide is classified by State law as either private or <br />confidential. Private data is information that generally cannot be given to the public but can be biven to the subject of the data. <br />Confidential data is infarmation that generally cannot be given to either the public ar the subject of the data. <br />The City of Roseville is collecting the information to determine qualifications to serve on the City Council. You are not legally <br />required to provide this information. <br />Other persons or entities authorized by law to receive this infarmation are City Council members, staff, residents of Roseville <br />and interested others. <br />I understand that all information provided in this application, except my telephonenumbers, fax number and <br />emai I address, may be distributed by the City to the public including, but not limited to, being posted on the <br />City of Roseville website. I agree to waive any and all claims under the Minnesota GovernmentData <br />Practices Act, or any other applicable state and federal law, that in any way related to the dissemination to the <br />public of information contained in this applicationthat 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 nature of the informationprovided. <br />I understand that the City will not publish my phone or fax numbers or email address without my authorization <br />and do hereby allow the City to publish (check all that apply). <br />✓home telephone number <br />work telephone number <br />✓emai l address <br />� � <br />Signature of Applicant <br />Applicntio�r D4010/a <br />� �� � � <br />Date of Application <br />.. <br />
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