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Ho�v has yoar vie�i� of the role of this Com►nission chanhed since your f�rst term� <br />[ feel fortunate in being able to serve dL�rin� interesti�z� and challen�ine ti�nes. <br />Other Camments: (Is�clude anyfiarther i»�or»2atio�r you ���ould like tl�e C'ity Council to co»sider o�� <br />lhul you fecl is� 1�elevcr�a! to re- appornt�ne��1. You �rt�ry also uliucl� n117e�' rnatei�ials• }�ozr �ti�otrlcl /zke the <br />C'oinacil to coj�s•idef'.� <br />"I�ennesse�i Warning - Some or all tlie informati�oit that ��ou are asked� to provide is classified by State la�r as eitlter �rivate or <br />confidei�tial. €'rivate da�a is inform�ition that benerall�� cannot be given t'o the public but can bE �iven to the subject of Che data, <br />Conf idential data is infor:nation that generallv cannot bc ��iven to either tlie public or ihe subject of the data. <br />��hc Cit� of Rose��ille is coll�ctin�r tl�e inf�ormation to determitie qualifications to se����e on a Cicizen Advisory Con�missioil. <br />l,�u r�re not legall�� required [o provide this information. No���ever, ifyou do ��oi s�ipply the information, you may not serve on <br />�, ��i�i�en :�dvisoi�� Cointnission. <br />Othcr persoi�s or entities autho��ized bv la��� to recei�-e this information are City Co�mcil mernbers, staff, residents of Roseville <br />a��d intcrested others. <br />I uiide��staiid t11at all i�lformation provided i�l illis application, e�cept my telephone nu�l�bers, i'ax number aild <br />email address, may be distributed bv the City to tl�c public incltiding, but ��ot liinited to; bein� posEed on t11e <br />City of Roseville website, 1 acree to ��raive any a�ld all claims under t11e Minnesota Government Data <br />Practices Act, or aily otl�er app[icable state and federal law, that in any way related to the disseminatian to the <br />����b1ic of infoi-�»ation contained in tl�is a�plication that wo�ild be classified as private under such laws. 1 <br />u��clerstand ihat l ma>> contact tl�e respoi3sible authority for tlle City of Rose��ille if I have any q�iestions <br />re�,ardi��r> tlle public or private nature of�the i���I�onnatio3i provided. <br />] �inderstand that ti�e City will not publisi� my pllone or fax nuinbers o�� e���ail address �vitllout my atithoi-ization <br />a��d da hereby allow the Cit}� to publisll (cIiec]< al[ that ap��ly). <br />�l�oi��e telephone number <br />��vark telephone number <br />l�ome email address <br />���orl< email address <br />James .T Dol�ert>>(electronic signature <br />Si�nattu•e of Appl'icant <br />Recrpj�outtnre��r7.Appftculron OJl /30 <br />12-1 �-09 <br />Date of Application <br />