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� What is your view of the role of this CAmmissean/Committee/Task Force? �__,� i � r � - — - -.•��.•�� - -- Other Comments: {Inclucle �rny�i�rr�ie� informati�n you would like the Cilv Councilto consider or � ��ra� w�r�. ±i� i,w relc�t!arr� ra t�a �o��r"�rrn�:f �o� �x�� s��n� �`rarr �r�� a�sa ��ae��r r�r},��,�,�r�r;�� k,�W would li]� r�r� Council to c'OYtSICJCI�.) �• � � '1'en nessen Warn ing - Some or all the information that you arc asked to providc is classified by State law as cithcr private or confidential. Private data is informationthat generttUy cannot bc given to the public but can bc gi vcn to thc subject of the data. Confidential data is informationthat generally cannot hc given to Cithet the public or thc subject ofthc dt1t�. The City of RosCVille is collecting �Ix informationto determine qualifications to serve on a Citizen Advisory Commission. You are not legally rcyuired to providc this information. Nowcver, if you do not supply :I� infomiation, you may not serve on a Citizen Advisory Commission. Other persons or cntitics authorized by law to receive this information arc City Council members, staff, residcnts of Roseville and interested others. I understand that all information provided in this application, cxcept my telephone numbers, fax ntunber and email address, may be distributed by the City to the public including, but not limited to, being posted on thc City of Roscvillc wcbsite. I agrec to waive any and all claims under the Minnesota Governmcnt Data Practices Act, or any other applicable state and federal law, that in any way related to the dissemination to the public of information contained in this application that would be classified as private under such laws. I understand that 1 may contact thc responsibCe authority for the City of Roscvillc if I have any questions rcgarding the public or private nature of thc information provided. I understand that thc City will not publish my phone or fax numbcrs or cmail address without my authorization and do hereby allow the City to publish (chcck all that apply). —11ome telephone numbcr work telephone numbcr �mail address �.,+� ra}�P� � �;�3i1:%J7� �7�.��rL'�LTiL �. �� ��,� � ��t�, � � �