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FROM <br />(WED)SEP 28 2018 10:38/5T.10:37ZHo.8300400788 P 2 <br />INDIAN RIVER COUNTY APPLICATION <br />FOR COMMITTEE APPOINTMENT <br />Name: .S II Date: &WkAer 2 ablt. <br />Full NamelAn=dix 5a A 0VZ15 SOU) kq Email Address: 'Ua110 0-4y" <br />work ; 0.�an��. @ Skylldveseb. c-om <br />Street Address (No P.O. Boxes): 3-2263 <br />Home Phone: )VIA —] Work Phone: m.-bu-sCell Phone: (010 - X70-51 (o <br />How long have you been a resident of Indian River County? 200 &.2o to OVA 4;, <br />Are you a full or part time resident? Check one: Full Time1XPart TimeQ <br />Please list current employer or business. If retired, please list any business experience that may be <br />applicable to the committee. <br />skydive, sebm-fan I <br />. <br />Ljoo Alrpoc-i' "tiYivc VkSf <br />�busfi a.n, Vic. 3ags-g <br />Please list any licenses you presently hold: <br />Please list any organization of which you are currently a member: <br />t1wk& %*qts Par Sou VS <br />Please list any other committees or boards you currently sit on- <br />NOrpt <br />Scbas+i&h Chamber of GYAMCrCt 7bW#5v-n m45S . <br />continued orr next page <br />'119 <br />