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Cityo; <br />Louisville <br />COLORADO ^ SINCE 1878 <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: ---7/400 (9 " • 75/41\.)41C/KIT A/ <br />Date of Birth: <br />Home Address: i3fo Ga l,tv QG( y Louisville CO 80027 <br />Home Phone Number: 3 %99 —063 7 Cell Phone <br />Email Address: Q U) @ (�D mat S 4- , i1 <br />V ( <br />Occupation: Ties( ? c)i -Jvt,Q( <br />Employer: B Ilte_ Q ol'l)S/ ,:.4-11c--.. <br />- <br />Length of Time Living in Louisville: 3'.3 <br />al S <br />Education: I)II N4\ iv t �r1 �w/'11 t n A, M - yi 404 C Q <br />` <br />J <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? 0 YES <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 of each applicant without discrimination based on race, color, national origin or <br />ancestry, gender, religious convictions, disability, age, or sexual orientation. <br />3 <br />