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City0t <br />Louisville <br />COLORADO SINCE lWIrig <br />2012 Application for Ward I <br />City Council Appointment <br />APPLICATIONS DUE TO THE CITY MANAGER'S OFFICE, CITY HALL, 749 MAIN STREET, <br />BY 4 PM ON NOVEMBER 30, 2011 <br />INTERVIEWS ARE SCHEDULED FOR THE EVENING OF WEDNESDAY, DECEMBER 7, 2011, <br />You MUST meet the following criteria to serve as a Ward I City Council member: <br />• You must reside in Ward I and have done so for a minimum of 12 months (see <br />attached map) <br />• You must be a registered elector <br />Name of Applicant: ThielJtv) <br />c-- <br />Date of Birth: /-4 <br />Home Address: WO Cia v\;C <br />�' "0 i <br />Home Phone Number: 3/ C` ` � % 6 Cell Phone Number: <br />Email Address: dpj(? ( id ;a S i <br />Occupation:Sf c') (i't�.�'"' <br />Employer: fU / c <br />Louisville CO 80027 <br />/2 9 o -61 <br />Length of Time Living in Louisville: \i-eY- c <br />Education: `) NN\ k ANY4AI o l) 4/1 1 ' vi C.0 <br />STATEMENT OF INTEREST: <br />Please attach a letter or statement briefly describing your interest in serving on the City <br />Council. Feel free to indicate any areas of expertise, background, concerns and /or general <br />information that may be applicable. You may also attach a resume or other information you feel <br />may be relevant to your application. <br />CURRENTLY SERVING ON A BOARD: <br />Do you currently sit on a City Board or Commission? ❑ YES L 4JO <br />If Yes, please identify that board. <br />It is the policy of the City Council to make appointments to the City Council, citizen boards, <br />commissions, committees, and task forces based on the needs of the City as well as the interests <br />and qualifications ofeach applicant without discrimination based on race, color, national origin or <br />ancestry, gender, religious convictions, disability, age, or sexual orientation. <br />3 <br />