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<br />r <br /> <br />e <br /> <br />. <br /> <br />BACKGROUND <br /> <br />INSTITUTION CITY AND STATE DATE LAST ATTENDED MAJOR <br />5ou; IJ lk ().shJ /) J 1 S. ~v J~ /17-6 <br />;>1~C:' ~:,} ~ j-1-?f.p ~ 1"fC.. t9~f <br />1iI~ , <br />:'i;.. <br /> <br />EDUCATION <br /> <br />Professional Background: <br /> <br />~/~ ~~tc-e. 7.t!!:c-)f <br /> <br />?-dr~~J <br /> <br />.~;~ <br /> <br />Community Activities / Hobbies: 7e~rv'"5 //"'JAL,/ <br /> <br />Referencesflude address and phone number) <br /> <br />t 1:~ fJri~Jr7~S~1!Jii::h~ <br /> <br />Additional Pertinent Information: <br /> <br />Goals / Objectives: <br /> <br />Attachments: YES ~ <br />You are welcome to anach additional information, such as, resumes, letters, certifications, etc. that further <br />descn"be your professional and personal background. <br /> <br />Please return this form and any attachments to: <br /> <br />.... <br />..':':'.':r <br /> <br />City of La Porte <br />City Seaetary's Office <br />PO Box 1115 <br />La Porte, Te.'"C3S 77572-1115 <br /> <br />Revised April 1999 <br />