HomeMy WebLinkAboutDreyer senior application, 12-11 Print form E-mail form
CITY OF BOZEMAN, MONTANA
APPLICATION FOR THE SENIOR CITIZENS'ADVISORY BOARD
Date: k Z — o l--
Name:
Physical Address: 01Z a O et�- „`
Mailing Address (if dif, erent): _ Po. ox tl°l2al g�t"'j�Cf
Email: a .10,4 a.�c,
Phone(s): 1-4 1 ( 0- q(o 7IT
Length of time in the Bozeman area:
Occupation: 0C_ �_A C 1 I",�^
Employer: _F: � L&O r� e Ftnw%,e- «z
Have you ever served on a City or County board? _ S
(If so, where,what board, and how long?)
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Please explain your relevant qualifications, interests, and experiences.
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References (Individual or Organization) Name: Phone:
IN 5P
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.