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. , ~ : 11 : : : : <br />r <br />; 3140 Del Webb Avenue NE <br />Salem, OR 97303-4165 <br />~ <br />~ 503-588-2424 Fax 588-0209 <br />~ E-mail: cherriots.org ' <br />~: : <br />~ ~ .~ n r r_~:: <br />('t, ~~ I. I i y:a <br /> <br />,.~ i <br />~ ~ ' <br />tl ~ <<~ ~, 1~~~ ~-._ ,-\ <br />1;~ 9 <br />~f <br /> <br />~ , <br />~ <br />; <br />~,~ <br />~~;;tE ~ ~ 19J7 , <br />Ol!'4~~ t#, f''ai it,~(~T ~`~ +.a~ a~^~' ~.i~~-• <br />~E~~~~ ;: E~ is~~:~=;~. _ ~. .~€~ <br />APPLICATION FOR APPOIN~'MENT TO THE <br />~i/'Lt~.i'"i~'L0~ <br />ELDERLY AND DISABLED CONSUMER ADVISORY COMMITTEE <br />Thank you for yo~;r interest in Salem Area Transit! <br />CLOSING DATE: FFZIDAY, NOVEMBER 28, 1997 AT S:OOPN( <br />(Please print or type all information) <br />DATE: [ r - .~ ~. ~ `17 <br />NAME: yU <~:~ ~~ P M A iZT~ n <br />MAILWG ADDRESS: !~~ H<~:~a t.~~,~~~ <_.r ~v <br />~Sa~~~ r ~~. '-)73C~, . <br />TELEPHONE: ~,U 3 ?~~i 3 -,;! ~:,t 1 <br />OCCUPATION: ~i:~ c-~1-,ied i'r~<.: ~.r~: ~~d r•;..t- Fi-~~~r,v,r~: {'~ .- <br />1 ~ y ~S, <br />~ Please describe your interests in serving on the Elderly and Disabled Consumer <br />Advisory Committee. What would you like to see the District accomplish in <br />relation to transportation services for elderly or disabled persons in our area? <br />„ . .. .. ,.~ ~ ,'1 <br />~r~ <br />~ <br />~ r.~-~ ~.~~QJ~;'y~-c~,~ ~~'Y1~1"l ~52.''~ _ ~~~_ ~.~''~_ ~~f' <br />~.'Y~.. C}-~', ~ ~ ` <br />~ ~ 3 ~. .~~..~.~-~ _ ,.~::_ ~ .~ d~- ~ <br />~~~ , G' <br />C~.~. c~1~. ~~-x-r~- ~~ '~.a-.~ .~,~ ~ . <br />~-~-~ ~~~~,_~- <br />~C ~2~.'~~-.~ ..~- --~ c~.~~- ~~.-L-~L -~ ~~:.1 Z =~-t C~-u, <br />,~,ti.~..~~.;. ~S, ~-%~-~f.~ ~t~ ~ .rh~,~ ,..,t:- u~~~-, cn,~ ~~c ~- <br />~ ,~~~ L ~-'"t~s_ ~.~t,c~ ~• u ~ ..lt.s..c-~.i~ ~~ ' ~'~ , ~ d r~-.4,,,,; <br />i " O '~ <br />CLv~.~.r~ ~,~,rr,~n Lt-"-~'•Em L~rL1z ..~~ c~~-e,~ ~+=~.1~u_~~c.,~.~, ~Zz <br />~"hs.,~-~-~ ~'.~zr:~- , C~ Sl;:,--~-- c~ ~~~ ~-i;,~ c:z:_ `~ ~~c ~~~-~`~ ~'-r~ ~~.~..~ ..~ <br />81 <br />