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How has nur view a� the rple of this Ca 'ssion cban ed SinC� Ypur f#1'St teFII1? <br />.�.., ti . ., -- � - <br />.�, <br />�+�u�r �,omranenta: (ln�lude anyfurther info ation you would like dhe City �'nune1l to eonsider or <br />thcrl you feel is relevant to re- a�poinhnertt, otr m�ry also �tt��ch pther materials you would like the <br />Council to consideY,) <br />�d <br />Teqnessen W'arning -$p� or all Ehe inforrnahon ihat u Sre asked to provide is c�lassified by Sta#e (aw as eiti�er privapc r <br />cpnkidentiaf. Private dsta is infoz-tnation that generaliy c ot be given to thc public but ean bc given to the su6jecc o�tk�e ta <br />Confidential data is infort�2tion that genera}ly caz4not be ive�i to either the public or th� subject of thc dara. <br />The City of Roserillc is Co�I.�CTiri� t]2C infp�tlOri t0 dC <br />You are not legally required to provide this information, <br />a Citizen Advisory Commission. <br />Other persons or enti[tes �uthorized by law tc� receive <br />and incerested others. <br />I iinderstand that a�1 �n�ozxraat�on provided in this <br />email adciress, rz�ay be distributed by th� C;ity ta <br />City of Rosevil�e website. I agree to waive any f <br />Pzac#ices Aet, ar any ot}ier applicable staie a�c� �i <br />public of inf�rmation contained in this appl�catio <br />understaz�d tlzat I may contact the respazasible aut <br />regardir�g tk�e puhlic or private nature of the infor <br />I understand that the City will not �ublish my x <br />ar�d da hereby allow the City to publish (check <br />home telephone number <br />�/ wozk telephone numbe�• <br />home ema�) ac� ess <br />�work emaii add�ss . <br />� <br />Signature of A,pplicant <br />ReappornnnenrAppltcauon ngll9p <br />rmine qualificacions to serve on a Citizen Adoisory �ommiasso�, i <br />owcvcr, if you do not supply the information, you may not set�v@ on <br />i <br />inFom�ation are City �nuncil m.embers, st�ff, residents of Rasevi�]c <br />�plication, except rray telephone nurz�bers, �'ax number �r <br />e publie iiicluding, but not limited to, being pasted on th� <br />d all cZaizz�s under the Miru�esota Govertur�enE Data � <br />eral law, that in any way related to the dissemxnation tc� t�ie <br />Ct�at wouJd he classified as private under such laws, Z � <br />�nty fox the City ofRosevi�le i�I have any quest�o�s ; <br />a#ion provided. � <br />C <br />e or fax ntunbers oz email address without my aulhori�a�ion <br />hat apP�Y)• ( <br />� <br />I�-�SLay � <br />Date of Application ' <br />. ; <br />i <br />i <br />