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City,fli Board and Commission <br />Louisville Application for Appointment <br />cowit,wo • biNcw iii 15 <br />Apphc rJons due by 4 Pm, November 15. 7u i a <br />You MUST meet the following criteria to serve on ANY Louisville Board or Commission: <br />• You must reside in the City of Louisville <br />• You may not be an employee of the City of Louisville <br />Name of Applicant: NI ah c 41 • A 11 e v� <br />Date of Birth: <br />Home Address: R4i 6-1. #hdieWs Lari-e <br />Louisville CO 80027 <br />Home Phone Number: 303-b{,s 1(24 Cell Phone Number. 3 fa 4l • bill <br />Email Address: h A vtic y.h • a I l e A'1 g Tam' ,tvvvi <br />Occupation: (CfiaaA 1'+0ru,riuvt advn`►n, sfiro CTr <br />Employer - W eV lii ev►ve r <br />Length of Time Living in Louisville: 2- rs <br />Education: 13A , Ih LS 4rom lAnNtvS'i'- Urbttvl-Chaw,pa+ih <br />On which Board(s) or Commission(s) would you like to serve? <br />You muy lridlci a up to three choices_ please rank them , - 3. <br />Board of Adjustment <br />Building Code Board of Appeals <br />Cultural Council <br />Golf Course Advisory Board <br />Z Historic Preservation Commission <br />Historical Commission <br />Library Board of Trustees <br />Local Licensing Authority <br />Open Space Advisory Board <br />Parks and Public Landscaping <br />Advisory Board <br />Planning Commission <br />Revitalization Commission <br />If asked, would you be interested in serving on a board you did not choose above? <br />/I Yes No <br />It is the policy of the City Council to make appointments to the citizen boards, commissions, committees, <br />and task forces based on the needs of the City as well as the interests and qualifications of each applicant <br />without discrimination based on race, color, national origin or ancestry, gender, religious convictions, <br />disability, age, or sexual orientation. <br />13 <br />