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`� <br />www.ci. roseville. mn. us <br />City of Roseville • 2660 Civic Center Drive • Roseville MN <br />Phone: 651.490.2206 • Fax: 651.490.2276 <br />�Q� ° � ��t�v`� <br />55113 <br />Application for Citizen Advisory Commission <br />Please check commission applyingfor: <br />o Ethics Commission <br />o Grass Lakes Water Management Organization <br />� Human Rights Commission <br />o Park and Recreation Commission <br />o Planning Commission <br />o Police Civil Service Commission <br />o Community Committee/Task Force(nume) <br />Student yd No <br />Name: �T E P t-t� �` �� � Applicant o Yes, Grade <br />Address: � 0 `� <br />.�. l � �'�, <br />v Rnseville <br />City/State/Zip: � a S�- v:� �� Q I� n(' S S 1)�j Resident�Years <br />Telephone: (Home) 6 5 } b � 9 - p `3 b �, (Work) .� ► Z `3`�� - � � `� Z-- <br />Email: S Za�2N �! C q w, han� �► v�� ,�c�u, Fax: <br />Work Ex� <br />J6Gc <br />� <br />� �w�N ��cvnl� I 9 �7 — i �i8, <br />�o c:� � UJor ►< .S� �2v t s:srz.. 9�� — I 9�� <br />��v.�a4 r,n�.-t:�� f-e..c,�►�nc,�o�.� .Sc)�x.rv�-�.�L I � ��' — 'i�'2��t�( � _.._.._ <br />�._�.�.. <br />--- <br />_�_._._ .LL_, �.......�...........�_ <br />Educallon: 3f� �°r Sous�� wo�x . Mrna i� t��rb�;� �c,�v►���5-i-►-��-�'oh <br />__ �vc.��,-c;-�c, �a (��% 1� �!+�►'+'� � h; st� c�:on ��K o✓'t,�c►�t.n�.�i.a� <br />Civic and Volunteer Activities: (Past and Present) <br />sev v�er� a.s � c�v �n'� � c�,'� t� 12aSS �D€�DS � a aP�-��nt it6�r�N G� . CG c�e� ivr�an c�,"�' <br />� v-i �.a� � rr� C l� v�� ( e�r a� �Ye 5 b•�. �- � w� �' �� �-c t� V� . f'e.�T c� a�n`t <br />Co�-i� o-�t s�ior�`-(���vt�S Ci�aii� o �cC.to�i�+inis��) ��oYnr�+�i-�ee � GYiUV'C� <br />� <br />c�--1.�;,.t��� o.� 3`nal� � o�� ���:�' e���t�i . <br />