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CITY OF BOZEMAN, MONTANA
APPLICATION FOR THE CEMETERY ADVISORY BOARD
Date:_ Jd, -OT, Z016?
Name: )6A'e''/k e
Physical Address: �Z
Mailing Address(if different):
Email: lilQc ¢c bt Itit vyt
Phone(s):
Length of time in the Bozeman area: 3 Z &j e a r-5-
Occupation: �LH
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Employer:
Have you ever served on a City or County board?
(If so, where,what board,and how long?)
Please explain your relevant qualifications, interests, and experiences.
' JLc'�J 61C�'rC / �Lt �E'i�Gt
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References(Individual or Organization) Name: Phone:
l 6a ue ���u r�LeCr' C'rY'c � 6-,?1? f35�5�0�
This application is considered public record. Application contact information may be displayed
on the City of Bozeman website.
PLEASE NOTE: Per Ordinance No. 1759, revising Chapter 2.01 of the Bozeman Municipal
Code,all board members are required to attend a yearly ethics workshop provided free of charge
by the City as a condition of service as a member of a board.