HomeMy WebLinkAbout120713 - Oath, Statement of Officer, Open Meetings - Mabelene C. Robinson (trff*4 SENIOR ADVISORY COMMITTEE
APPLICATION
CITY 01' COLLEGE STATION PARKS AND RECREATION
Horne of Texas A&,Lf University* 1000 KRENEK TAP ROAD I COLLEGE STATION, TEXAS 77840
(979) 764 -3486
PLEASE PRINT
1. Full Name: F I a g E LEN I l 1 (1 , 1 I 4 �j U! � Y l
RST MIDDLE
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2. Home Address: 1 ii EI VV, if D d ,o4L ,6 t - 5/ 7i„il1 7 "
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STREET CITY ZIP CODE
4. Contact : i d • — 1 * 7 1 l 1 l
Information H•ME P 0 E CELUWORK PHONE EMAIL
5. Residency : I' I /VW 1 1 l
Information VOTER'S `EGIST " RATION # YEARS AS ESIDENT O CS SUBDIVISION LIVING IN
6. Professional: Ja - Ott-4 , v 1 /g6 D1.
Information OCCUPATION *If business owner, NAME OR.BUSiNES l
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EDUCATION optional)
Please list any Boards /Commissions /Committees you currently serve on:
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Please list any experience or inter is that qualify you to se'- in the positions indicated:
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* *All applicants must be a College Station Resident & Registered Voter
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ATURE OF APPLICANT
DATE