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<br />Application for Appointnlent to <br />Citizen Advisory Boards and Conlmissious <br />.. <br /> <br />I <br />--)\tP <br />J/ <br />v/ <br />I <br />v/ <br /> <br />c.:::..:.:.......... <br />fA ...m.m......,: \ <br />Ifc:n-':.. ~. ) <br />\,., ,., .\. I <br /> <br />\~~~ <br /> <br />Name of Hoard, Commission} or Corumittec <br /> <br />HUMAN RI~HT~ <br />nO._u___.nnu.uu___ <br /> <br />COHN\SSION <br /> <br />Pleo>..\'e !Jriht or ~YI)e <br /> <br />Name <br /> <br />PALOMA <br /> <br />,.. <br />ALlC.IA <br /> <br />P.El..A <br /> <br />Fits! <br /> <br />Aftddle <br /> <br />Last <br /> <br />Home AdGress <br /> <br />lCjy~ <br /> <br />Kn-.tc.AI D <br /> <br />~T:hmmn.m~h~nSn~ N E} 0 R ~mhnnm~n!.~.Qu?__.m <br /> <br />Street <br /> <br />Cizv <br /> <br />ZI]) <br /> <br />Home Telephone <br /> <br />(SY \) 3.:?~~.!.9..Y.7..u..um.u__ <br /> <br />Daytime Telephone <br /> <br />n.l?Yu1j 3 3 {) - I QUYhJ.n <br /> <br />Do you reside witb in lhe city Urn Us? <br /> <br />~Yes <br /> <br />o No <br /> <br />{rye:;, bow long? ..nhwmm.3m n''i..~nA.~.?u.. <br /> <br />City Council Wmd <br /> <br />3 <br /> <br />Neighborhood Organization <br /> <br />A 1--1 A LON ..m.":'l.f;.lnf~}.i.i!~)~~.hmuuuun. <br /> <br />Occupation/Place of Employment <br />uuum._._~.'? U C. A -n DNA $.?\..~.TAnNnr.n~mnJ:LLYum6u!:-:_~. I A NeE <br />.J~. {P &. f; A R. () E N A V f.. .h~:.YS.~.f-,.l.fn!.m9~..:hn52.Y.Qu~uu_._....__h.hm.h <br /> <br />Business Address <br /> <br />Fax number (If applicable) hh.N:A..~hmmmmn <br /> <br />o I'kwspaper <br /> <br />Email (if applicable) p r t,7. a @ uo r-e q on. e d u <br />edu_ 8SSlst 2. e hi"",'}!! f &nce. <br />org <br /> <br />Hmv did you learn or this vacancy? <br /> <br />)( Word of MOUlh <br /> <br />o Mail <br /> <br />o \Veb page <br /> <br />Other somce <br /> <br />i'l()TE. Inj{)rrnarion consisting oj~ hOinr:.r addresses and phone nlonber.'J lnay be exert:}n.fi"ofIidiscfosure pet (JJ?S 192.50)(3). <br /> <br />OPTION~4L INFORJJIA TION <br /> <br />The Eugene City Council sU/iports ,fiversity and seek.s to Gj1point persons 1-1410 re!Jreseni the ,,-liversity oj'the cornrnufii(v !~}' <br />pro"!..'iding {he injorlnatiori. be!o11/) you can. het~u the C"it}: (;ouncll to kno'yv ~rthe illJjiointn?enrs !lralch the (jjversity oj~ the <br />C(}J'll!rfun i(v. .Applicants are considered }1,rit!zOUI regard to race.. sex, c{}!ur, national origln~ age, reifgion, fnarit...-d status, <br />lnediciJl condition, or disability, Tn sorne instances, hOH)eVer~ a~Dpoint.YflE:nt to c'ertain boar{l}'/corruni.sst"orl,S' n:ay be based U[J()}1, <br />{he need to jHl specij?c ])OSitiO'tlS on the board/collln;ission. <br /> <br />o Male <br /> <br />'M ;::a, la <br />~......na.!..... <br /> <br />o 11\ and under <br /> <br />D ] 9-25 <br /> <br />rd" '3- <br />'fI'-/..{J-. ) <br /> <br />o 36.45 <br /> <br />o 46-55 <br /> <br />o 56-65 <br /> <br />066+ <br /> <br /> <br /> <br />hl::ltlckr <br /> <br /> <br />o <br /> <br /> <br />\\C\:srvpp09\pu b hc\C~d (rJ3cards :3nd Cornrn j:~s:i0ns \}(JOSBCCapp! lCi:: jon(h~c <br />