Laserfiche WebLink
<br /> <br /> <br />S!.TE OF COLORAD <br />APPLICATION FOR BOARDS AND COMMISSIONS <br />OFFICE OF THE GOVERNOR <br /> <br /> <br /> <br />Please attach a current resume <br /> <br />BAS <br /> <br />Be 1 <br />BCl <br />Bca <br /> <br />Doard Of (;O","'I:);)lon rO~ whiCh' yov ..,~ ~g"lying: <br />rkansas River Com act Administration <br /> <br /> <br />YOUH NAMI: (Lasl. First, Mlaalel <br /> <br />Counly <br /> <br />cooqre5Slonal <br />Dstnet <br />4 <br /> <br />~en:ue Oi$t, Mouse 01$1. <br /> <br />2 63 <br />Stiue ZiD COQe <br />CO 81052 <br />Race: (clfcle OM) African American Asian <br />Un HISD8nlt Native Atl\Gtlc8 &ucasia <br />Residence Phone No. <br /> <br />James G <br /> <br />Prowers <br />City - <br />Lamar <br />Regn>lGtea voter eS r No <br />Panv AIIlIiallon Rep. <br />F CitcleOM <br />Sus,n8SS P"ono No. <br />N/A <br /> <br />(719 )336-2124 <br /> <br />Yout Occupation <br />Farmer <br />p",aon, ~Y"r <br /> <br />8usinw:s Addt... <br />N/A <br /> <br /> <br />o ed <br />eOUCATION AND QeN~RAL ' UALIFICATIONS: <br /> <br />LEVEL <br /> <br />NAME OF SCHOOL <br /> <br />LOCATION <br /> <br />No. Yeats Old You <br />Attetu'ed GrsQ.uate? <br /> <br />MalOr Couts-etsl <br />of Study <br /> <br />High School <br /> <br />College <br /> <br />rrede/BuslnesIJ/CorreSl)On<I't\Ce <br /> <br />4 <br /> <br />Lamar CO <br /> <br />es <br /> <br />Memberships in <br />Organizations <br />and Offices Held <br /> <br />(Indicate If Past or Present) <br /> <br />ARCA 10/1/85 - 8/16/93; Treasurer <br />Lower Arkansas Water Management Assoc. President curre <br />--- <br />Bo~rd Member & President Hyde Ditch current <br />Past President Lamar Jaycees <br /> <br />Volunteer Activities <br /> <br />(Indicate if Past or Preaent) <br /> <br />Special Skills and aualllicatlo~s <br /> <br />(Including disability status, <br />if desired) <br /> <br />"resident and water ri ht owner Water District 67" <br /> <br /> <br />resentative <br /> <br />8 <br /> <br />REFERENCES (list three persbns. not related to you. whom you nave known for alleast 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 />303-866-3530 <br />719-544:-2040 <br /> <br />1313 Sherman St., RID 818 80203 <br />P.O.Box 440, Pueblo, CO 81002 <br /> <br />I certify tnat the facts contained in this applicatiOf\ are trIJe and correct to the best of my knowledgl;t, I authorize investigation of all <br />statements contained herein a:nd the references listed abO\le to give YOu any anQ all information concerning my Qualilications and any perti. <br />nent I"formatiot"l they may have. personal orothelWise and release all parties from all liability for any damages lhat may result Trom furnlSO- <br />ing the same to you. <br />Is there anYlhing~our background wnich might be a pOtential embarrass-ment to the Governor or you if il were to become public? <br />yes ~ . If yes. 01ease eXplal11 on separate sneer 01 paper. <br />I und~r$t:and that the Colonldo Public Records Law rnay reqLri(8 I"at certain inlormatio., contained on thIs <br />AE"I'UAN COMPL.ETEO FOFl:M TO: aQpllcatlon be accessible to the general public. except when specifically made conlidontial by stalute. <br />Karol' Rok.l. <br />Olr8ctor <br />BOO,r<2S and CQmmlBliona <br />Ollir;e of The Go...ernor <br />136 :jlate Capi101 eUllQlng <br />Denver, COloralSo 80203 <br /> <br />- <br /> <br /> <br /> <br />SIGNATURE <br />