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��� q UTA <br />www. c i, ros evi I le. m n. u s <br />City of Roseville . 2660 Civic Center Drive . Roseville MN 55113 <br />Phone: 651.490.2206 . Fax: 651.4902276 <br />Application for Citizen Advisory Commission <br />Please check commission applying for.• <br />❑ Ethics Commission <br />Cl Grass Lakes Water Management Organization <br />� Human Rights Commission <br />❑ Park and Recreation Commission <br />❑ Planning Commission <br />❑ Police Civil Service Commission <br />❑ Community Committee/Task FOrce(name) <br />Student I� No <br />Name: av" rI� a�= . ���� c��,� t Applicant ❑ Yes, Grade <br />Address:��t 0 D .�; a �:� r' � �e'v� v�_ <br />� Roseville � �-a���'�,<ta 1� s`+����. :: j <br />City/State/Zip:_�05�. �'r ( le. /� rv S�� I f� `� .�45 Resident �..s Years <br />Telephone: (Home) �� Sf� � $ 1 - � � riG' (Work) (��S I� �'�0 - (� I �5 � <br />Email: ,�'►� �1�r ,� e5��� �c� .5�%<ai"� � cr �v Fax:1(�i ,1 ��iv . �3 n�_,� <br />� <br />EducaHon: Lt. /.�. l v� fr�,- �°i.� /h.�rn � Co���vu,, ca �,•�;r �'�/�%n /�% $� <br />Civic and Volunteer Acfivities: (Past and Present) <br />o t�» .� r,u-� y't�t e' �v� �p� r J( r3 ; e v; l l c J� , s f�.- �, tz, s s« c-, � 7i �su v� o c t- �� � <br />� <br />C� t.� � 1, ,�� 1 i i '�' C�,t.; � C':. �t n.n !} v� .� a�.s v, <br />