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� <br />What is your view of the role of this Commission/Committee/Task Force? <br />_--__---- - _ - - <br />�'�!�r �'�rn� �5���� ��a�l� ��r,�* � � r� � ����s� �# d.�. <br />��_� ��'� �� r � �_� �_�t f� ��� <br />�,�t�` v <br />�����r � <br />Other Comments: (Include any further inf'ormarion y+�u would like the Cr�y Council to consider or <br />that you feel s Nedevant to the appointment you aNe seeking. You may adso attach otheN mateNiads you <br />would likc lhe Councid to conside�! _ <br />�_ �� � �_ � � �r s � ��,�� � �� � �,�e � r,� �ac � ic.+ � �� � � � +w.+ � �� �� �� �+ ��� � <br />� <br />� <br />w r �S r ���..�� S _ <br />� ��� � � � �� �� <br />�r �+ �x��a � d <br />r � � .s #r � +�r c� � �r <br />�� �� <br />��� � ��� � �� � �� ��������� <br />��+ rr�s �� �� �r �r� # � c � <br />rs <br />v.�n �r# �� �� fi'�� <br />fitnnea�rn n.in� 5or�� or ell L4�e ;,Fp^r_ati�q I�ok���� are zp�ed tn�ra•��idc is el������i h} 5rxic I■x �a.•i�5isi �ri VaR� 4F <br />eonEid4nciol. ,privAt� data �5 information that generally cannot be given to thc public but can bc given to the subject of the data. <br />Confidential data is information that generally cennot be givcn to cithcr th� public or thC subject o f thZ data. <br />Thc City of Roscvll(c is collecting ihe informatiott to determine qualifications to serve on a Citizen Advisory Commisgion. <br />You �;: not leg2lly required to provide this information. However, if you do not supply th� inlornt�tiott, you may not 5��'t or� <br />a Citizen Advisory Commission. <br />Other persons ar cntitics authorized by law to receive this information are City Council mcmbets, staft', residezlt8 ti�f Ro;Cville <br />and interested others. <br />f understand that all i�ifonnatioi� provided in this application, cxcept my telephone numbers, fax number and <br />e�a�ail address, may be distributed by the City to the �ublic including, but not limitcd to, bein� posted on the <br />City of Rosevil(e website. 1 agree to waive any and all claims ttndcr the M�iz�z�esota Government ba.ta <br />Practices Act, or any other applieable statc and fcdcral law, that in any way related to the dissemination to thc <br />public of information containcd in this application that would be classified as private under such laws. I <br />understand that I may contact the responsible authority for the City of Raseville if I have any questions <br />regarding the public or private naturc of thc in£o�naatio�n provided. <br />I undcxstand that the City w�ill notpublish my phone or fax numbers or email address without my authorization <br />and do hcrcby allow the City to publish (check all �};ati apply). <br />ft�a�ue telephone numbcr <br />��ork tE�ep�.one number <br />cmail address <br />� .���. �-��-�� <br />5ignature of Applicant Date of Application <br />e�p�Ku'�n�1 i? <br />�� '� <br />' ON Xd.� <br />�i� 5 � ' �� h��i� ����-� l -���,� <br />