Laserfiche WebLink
� <br /> � <br /> Cil�► Of <br /> Pe uot <br /> q <br /> Lakes= -_ <br /> DATA RELEASE FORM <br /> In accordance with the Minnesota Government Data Practices Act,the City of Pequot <br /> Lakes is required to receive your consent before releasing any information about you that <br /> is classified as private data. Private data is information that is not available to the public. <br /> If appointed to an Advisory Commission or elected as a City Official,I authorize the <br /> City��.t�a�e§to disclose t�e following�nforan��io�.You must�hoose at least <br /> one phone number or e-mail address to be made public. <br /> (� Board and Commission 1_�b��t�_ �c�� <br /> Q� Name ' <br /> ❑ Home Telephone Number <br /> ❑ Home Address <br /> [� E-mail Address � <br /> . � <br /> . <br /> ❑ Work Telephone Number <br /> ❑ Cell Phone Number <br /> ❑ Other <br /> Signature: ate• �p. 7 p . ��p <br /> This release will be in effect as long as you serve on the Board, Commission, <br /> Council, or Task Force and can be changed upon your request at any time. <br /> S:�Administration\City Clerk�Boards and Commissions�Application Process and Forms�F'ormsWpplication Form for Boards and Commissions.doc <br /> Page 5 <br />