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HomeMy WebLinkAboutAgenda Bill 4.A-Stewart 11/15/20101.0/25/2010 14:46 203; -- ,.3 -0550 FEDEX OFFICE 0326 PAGE' 01 T OP if V151 4" tLi1,11 C'1!� lt,rs'.: ' ��# '`��►�i�d = �asr�n�ti�s���t �f�i +�titriiif�e� ��i�ii ' � y Instructions: ` Use 'ahis form to apply to serve on any of t'he City of Petaluma, California's Boards, Conimissions, or Committees. please fill 4�ut`the form completely. If a question does not apply: write NIA in the space,provided. Wher. completed, please forward to the City Clerk's O Petaluma, I I English Streeet, Petaluma, CA 94952. All applications are reviewed by the City cil. Nar L �n CZ t W+�rtte ,tiees~f,' 8� d�kitl t�5tie,'�� 9 /due. VIV P P e t.�� .► -r.a- L . 10 Wmirihe fyfiah+� ff:ir nfed eto y ou'� Inftfis ( . pp oi nufitb�Pta:tae dt�cirl�ible'fd 4Wk.;Pho irN: S U �VC3 - IUlailt (►f tlppr�mt d db you vircfhf this oddtoss to ' e be Evt�1lak�le._ td }H publre ?).. (� . ) ��'�;.� ta:r,..� @ _ _L°�S'ti•Y.. cos t~ �n� -f - J�rrE�:.yts�i t�:6regi trt�Pedf.veyl+ Il w i�et�alWnhd� - II so, d hr�vv iarY :? YES NQ t I GQ►wS B si ct9(s), :�onnt is�i�v�i s), or o�ir f ie6 of thtere t ++ 1 - *N,)fe: To seirve:on'the Seni-. ,advisory CommWee, you must,be age 55 ar cibove. Hir rre ►�s cat rtd c ty r e 6 o f h I Have you �eN t�fi 1 1 ON 6W6d ' or a��tipli�d. fl�r : titil§ bads MV but a YES Na ❑ YES ,� NO STEWART, H OPE 10/25/2010 14:4 - 6 203- -319 -0550 FEDEX OFFICE 0326 PAGE 02 I�pvp`c �►r- �hori�t�bl+� �Sr�nhixc��+de�t�;�rhi�fh ga�:h�err�,��l�shg�d> �dsi���n�1�Mi��eHelcl,�.aei�.: pd�r� O 1 "45 lc 1Du� ..y`�1 l°ge'�.�o... I M Vb \ta , , t �ra -�Jk -� �� ta•�w...� �d..� � � �.Jb �d �- �t�.�_ �M �Se.�_ 1 . 1 9# 5�i��ci�i Int�r� t jSi�ills l+d1 � aced � u bran t t6 � id; C-bhAM till I, fir' Ci�imrriii 66' S kA\ s I LOY', . y S k: l l f � 'T' LtJ Ai PE P. f a�5 10/25/2010 14:46 203 - -319 -0550 FEDEX OFFICE 0326 PAGE 03 c�ri � , pt+�f dontli. V6cd 16fid '.s t���ti t�4 r �tl � ajorr ubp #, bpi $. I gr�6)�' t ) o Sp cldl Avud - ds or k o n P bh Ri rb�oi�gtty yoi1 waiait iPo bE��bt»e:Cr rn�rrbk�e� d�'�k�ld;'e�drdlrnit4�iss�ari fir G ��rrriniit :ik6Yr llr� Fi 4 � if ots�dec4ly s- �rt�tt.vir�ouldlJ4 fkihd4dW r �m u rile er of i hit dd. it tY- i s 'C v-� t► � �--(�, -- �e 1- �fw� �-„s �°�`"— t�—� -: w, a �.► h�a�_. � - ►...1 LA, 03� �� 10/25/2010 14:46 203 -- 319 -0550 FEDEX OFFICE 0326 PAGE 04 vl-,)uf Revised August 12, 2008 D37