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{and more if needed). T am camfartable reading and reviewing grant applications and assessment reports. I am comfortable with and supportive ot on-line cammunication formats and would be able �o advocate for their use within the scope of board needs. I can brang analytical and practical skzlls to the table with an enthusiasm for conservation and a respect for community needs. Thank yau for your time cansidering my application, T appreciate �he opportuni�y. I understand that al� information provided in this application, except my �elephone n�amk�er, fax number and email address, may be distributed by the City to the public including, but not limited to, being posted on. the City of Roseville website. I agree to waive any and all claims under the Minnesota Government Data Practices Act, or any othar applicable state and federal law, that in any way related to the dissemination tio the public of information contained in this appliCation that would be classified as pri�ate under such laws. T unders�ana that I may contact the responsible authority for the City of Roseville if I have any quest�ons regarding the public or private nature of the information provided.: Yes I understand that the City will nat publish my phone or fax numbers or email address withaut my authorzzation and do hereby al�ow the City to publish (check alI Chat apply}.: nat checked Day,_im� Phone: Evening Phone: Cell Phone: 65 Home Phone (if different}: Work Phone (if diffezen�): Home Fax: +^; or}: Fax : Home Emai1: work Email: Student Application: No If yes, pl�ase list your grade: May we contact you using your wo�k email or £ax�: Yes I h�-:ve read and unders�and the statements on this �orm, and I hereby swear ar affirm that Clic: stat�ments on this form are tru.e. : Yes Additional Information: Form submittecl on: 12/31/2009 14:09:11 AM Su}�mitted fzom IP Address: Form Address: http://www.cityofroseville.cam/forms.aspx?FID=237 2