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<br />09-21-93 08: 33AM <br /> <br /> <br />FROM GOVER~'S OFFICE TO 98554474 4It <br /> <br />STATE OF COLORADO <br />APPLICATION FOR BOARDS AND COMMISSIONS <br />OFFICE OF THE GOVERNOR <br /> <br />P002 <br /> <br />FOR OFFICE USE: ONL Y <br /> <br />Please attach a current resume <br /> <br />BAS <br /> <br />OOArd 0' CO"'1T'l13310n for ......hi"t'o )'ou oar~ O)pPlying: <br />rkansas River Com act Administration <br /> <br />ac 1 <br />BC2 <br />ace <br /> <br /> <br />YQUH NAMt;; lLast. FIrst. M'aGIeI <br /> <br />County <br /> <br />C~res!llOO8.1 <br />Oistnet <br />4 <br /> <br />Senate OiSl. Mouse DI$t. <br /> <br />James G <br /> <br />You' OcCUgalion <br />Farmer <br />PI'888n1 e~loyer <br />Se <br /> <br /> <br />Prowers <br />City <br />Lamar <br />Gender ReglSIGrea vote' <br />F panv ArlHiatlOn <br />CitcJ&One <br />8usu'uIss P"one No. <br />N/A <br /> <br />2 63 <br />Slate Zie Coos <br /> <br />CO 81052 <br /> <br /> <br />as r No <br />Reo. <br /> <br />Race: ((:trcle onel A1rican American <br />UII I1lsDinle Ntll~ America aucasi <br />Residence Phone No. <br />(719 )336-2124 <br /> <br /> <br />10 ed <br /> <br />BU:Mllr.r.t Addrno <br />N/A <br /> <br />EOUCATION AND GENERAL QUALIFICATIONS: <br />LEVEL NAME OF SCHOOL LOCATION No. Years Old You Major COUtiel$1 <br /> Attended Graou8le? 01 Study <br />High School ""mar Lamar. CO 4 ves <br />College NO <br />r'8d8/Buslness/Correapondet\C8 I <br />Memberships in ARCA 10/1/85 - 8/16/93; Treasurer <br />Organizations Lower Arkansas Water Management Assoc. President curre I" <br />and Offices Held -- <br /> Board Member & President Hyde Ditch current <br />(Indicate If Pest or Present) President Lamar Jaycees <br /> Past <br />Volunteer Activities <br />(Indlcat.. if Past or Present) <br />; <br />Spacial Skills and aualllicatlo~s IIresident and water riaht owner Water District 67" <br />(Including disability status, 8 vears exoerience as ARCA reoresentative <br />if desl red) <br /> <br />REFERENCES (list three pers~ns. not related to you. whom you have known for at least one year.) <br /> <br />NAME <br /> <br />ADDRESS <br /> <br />PHONE NO. <br /> <br /> <br /> <br /> <br />Davi <br />Hal Sim son <br />Tommy Thomson <br /> <br />1313 Sherman St., Rm 818 80203 <br />P.O.Box 440, Pueblo, CO 81002 <br /> <br />303-866-3530 <br />719-544:-2040 <br /> <br />I certify tnallhe lacts contained in this application are trUe and correct to the best of my knowledgt:, I autl"lorize investigation at all <br />statements contained herein a:nd the references listed above to give YOll any and all information concerning my Qualifications and any perri. <br />nent information they may have. personal or otherwise 3nd release all parties from all liability tor any damages that may result from rurnlsn- <br />ing the sarna to you, <br />Is there anyt"ing~our baCkground which might be a pOlen1ial embarrassment to the Governor or you if it were to become public? <br />yes ~ . It yes. "'ease explain on separa1e sneet or paper. <br />I undOrSl3nd that the Colorado Public Records Law may r~l.Ji(e 1"81 certain inlormation contained on thIs <br />appucatlon be accessible to the general public. 9:a:COPt when specifically made t;onlidential by statute. <br /> <br />lOl!;;rUAN COMPL.ETf!O FORM TO: <br /> <br />K.,.o" Rak.la <br />Ol,.eelor <br />Boo.rdS and CQmmlaaions <br /> <br />Ollic:e of The Go'WernOf <br />136 ::Slate Capi101 6U1IQlng <br />Denver, COlorado 80203 <br /> <br />SIGNATURE <br /> <br />DATE <br />