APPLICATION FOR APPOINTMENT BIKE EDINA TASK

City of Edina · 4801 W. 50th Street · Edina, MN 55424

APPLICATION FOR APPOINTMENT TO
BIKE EDINA TASK FORCE

* indicates a required field

Personal Information

*	Name:
*	Street address:
*	ZIP code:
*	Home Telephone:¹
*	Business Telephone:
	Email Address:
*	How many years have you been an Edina resident?

Occupational/Volunteer/Professional History

	*	Employment (firm and occupation):
	*	Civil, professional, community activities:
	*	Previous public experience (elective or appointive):
	*	Education:

*	Briefly list aspects of your skills/experiences relevant to the bike task force.

In what capacity would you like to participate?

	Helping Coordinate Neighborhood Meetings (few day commitment)
	Attend Neighborhood meetings (evening commitment)
	Help with Street Condition Inventory (few day commitment)
	Other (please specify):

¹Please be advised that information provided in this application is subject to disclosure upon request under the Minnesota Data Practices Act.