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Cityo <br />Om Louisville <br />COLORADO.SINCE 1878 <br />2019 Board and Commission <br />General Application <br />All applicants must complete this general application AND ALSO submit the <br />supplemental questionnaire for each board to which you are applying. <br />You MUST meet the following criteria to serve on ANY Louisville Board or Commission: <br />• You must reside in the City of Louisville (exception for Business Retention Cmtej <br />• You may not be an employee of the City of Louisville <br />Name of Applicant: (I' txr- Wk <br />Date of Birth: <br />Home Address: <br />q. t O S • Q ��, 4°42. Co L'�L o'S^ l[-c <br />Home Phone Number. S- g:o- g 22-4' Cell Phone Number. <br />Email Address: h.U10 SVW°�' - AL, 0 J <br />Occupation: A k- V1.01^1L krbkitt <br />"At WIC" — <br />Employer: <br />Length of Time Living in Louisville: 1- <br />Education: TSAI Cvko.ate Loll e-i <br />Ca_ U Pd Li # ( sue: <br />W1 A u GD <br />On which Board(s) or Commission(s) would you like to serve? Q S `L et-( <br />'u must also complete the auestionnaire for each board to which you are applying. <br />[] Board of Adjustment <br />Building Code Board of Appeals <br />Business Retention & <br />Development Committee <br />Recreation Advisory Board <br />l Revitalization Commission <br />O Sustainability Advisory Board <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 />