HomeMy WebLinkAboutHazelbaker, Green Ribbon Application Sep 29 2009 9: 57AM HP LRSERJET FAX p. l
CITY OF BOZEMAN,MONTANA
APPLICATION FOR THE MAYOR'S GREEN RIBBON TASK FORCE
Date_ g L..,.,? �4 a��
Name: 7:rh e 9 cJc— 4114
Physical Address: _ -2/O 14 . 9 l�11 J i ZiCT NSF�`�
Mailing Address(if different): F
Email: 4- v a.
Phone(s): cSg'7 -- Sf q /-:r 4 9 — 3 '7 L
Length of time in the Bozeman area: l�
Occupation:
Employer: � c--
Have you ever served on a City or County board? _
(If so,where,what board, and how Iong?)
Please explain your relevant qualifications,interests, and experiences.
References (Individual or Organization)Name: Phone:
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This applicafion is considered public record Application contact information may be displayed
on the City of Bozeman website.
Please return application to:
City Clerk's Office
121 N. Rouse, Suite 1021 P.Q. Box 1230, Bozeman, MT 59771
agenda�bozeman.net
Fax: 406-582-2344