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<br />Disability'? <br /> <br />DYes <br /> <br />~NO <br /> <br />If yes, please describe __"hn........_ <br /> <br />Fluent in Jangnage(s) other than English? <br /> <br />DYes <br /> <br />~NO <br />HA\lE <br /> <br />If yes, please list .....hh_hh..h.........n...._.._...._.. <br />2 'I EA~$ oF' SPAt-JISH <br /> <br />NOTF LU ENT I HowE V ER. <br /> <br />!. What experience, training, and/or qualifk:ations do you haye for this pankular board or commission? <br /> <br />PLEAst. SE:.E: ATlAC Hal) < <br /> <br />2. \Vhat specific contribution do you hope to make to the board or colXllnission? Why do Yl'U 'Nant to become a member? <br /> <br />PL~A S~ <br /> <br />SE.E: A rrACf-jEl}. <br /> <br />l'./()TE: To alli.r",.> (f large numher <:?f"citizens to serve (Hi b(){J.rd~l; and corrun iss ions, the CilY ('ouncit po!i(), allows individuaL.:; to serve <br />on ortfy one standing board or (o!nJnis,-~"ion af a tittle, A current rnembey (~ra h.-J(-u'd/cor!l.>>?ission who is (f ~'ti.cce.'\sflJi apJ-7h...:'ant .for <br />another f.;(}{trci/conimis'sion l1/ilt be required to choose helv,h.~en the tH/O app(f!nt!!'lents. This pc>licy does not (~f~piy to ad hoc <br />co({unittces or di:j)(lytrneJ1tai cO/Jua'iUees or posifiot>.-.-'i that are designated for Hlernbers (~{ SfJc.:."'Uh: ad,:"is()y..v grou.p (e,g the r!Un~an <br />l?tOgh.ts (~on~lnis..'t'ioJ1 !neraner a.S's!~gn.ed to the PO/iC2 (~omfnissio!l;). <br /> <br /> <br />or <br /> <br />Information submitted on this application is public infommtion. The intoml<ltion provided herein is true and complete. A <br />faIse or misleading statement may be cause for elimination th)H1 consideration, <br /> <br />/~ d w-'., < <br />: .. .,.-#_ j .1 <br /> <br />I ,io.}.Ol'i. OJ..u.n _ _MJJ:L." { . <br /> <br />Retnm completed applications to: <br />City Managu's Office <br />777 Pearl Street, Room 105 <br /> <br />Signature of Applicant <br /> <br />Date <br /> <br />I <br />I ~ <br />.......LLjUnJI05 <br /> <br />I <br /> <br />\\C e srvp p09\p uh 1 j c\ctvIO\B 0 iuds (j[i deo n11n is s iens\200 5 Bee ap pl ic ati~ln .d~ !~: <br />