Please submit one form for each board or commission.
Please upload a resume, CV, or personal statement noting any additional information you wish to be considered.
Please list memberships in organizations and volunteer activities noting any officer positions. Indicate if these are past or present and the length of time served.
If you are applying for the Wildfire Risk Reduction Task Force, please include specifics as it relates to wildfires, risk reduction and your passion for this subject.
Please include at least three references (professional and/or personal) in the box above including phone numbers. Do not include individuals related to you.
Are you currently, or have you been in the past, an employee of a nonprofit organization?
If yes, please list the name of the nonprofit and your title in the box above.
The Community Development Advisory Board (CDAB) meets monthly on the 4th Thursday of the month from 3:00 p.m. to 4:30 p.m. Additional meetings will be required during grant selection process. Will you be able to attend meetings more often than once per month?
The Community Services Advisory Board (CSAB) meets monthly on the 3rd Tuesday of the month from 3 to 4:30 p.m. Additional meetings will be required during grant selection process. Will you be able to attend meetings more often than once per month?
Please select the county you would be representing on the Tri-County Workforce Development Board.
Workforce Innovation and Opportunity Act (WIOA) requires that private sector members be the owner, CEO or other individual with optimum policy-making or hiring authority. Do you fulfill this requirement?
WIOA requires that public member organizations have expertise in addressing employment, education or training needs for individuals with barriers to employment. Does your organization fulfill this requirement?
Please mark all that apply to you:
Members shall be either a Professional Engineer registered in the State of Colorado, specializing in civil, structural or soil and foundation engineering, or a professional geologists as defined by C.R.S. 34-1-201, 1973, as amended. All engineers and geologists shall demonstrate substantial knowledge and expertise in the methods used to identify, investigate and mitigate damages due to steeply dipping claystone bedrock. Note: Jefferson County is seeking individuals that have a geological and geotechnical background in Designated Dipping Bedrock Area.
Do you have any scheduling conflicts that would affect your ability to attend board meetings?
If you do have a scheduling conflict, please explain and provide those details here.
Do you have any personal or business interests in matters before the board for which you are applying?
If you do have a personal or business interest, please disclose those details here.
By clicking the box marked 'Yes' I acknowledge that I have read and understand the duties and functions of the board or commission, including the duties and obligations of persons serving as a member of this board or commission, and that the board or commission may, at times, require several hours per week outside normally scheduled meetings and hearings to perform site visits, review staff reports, attend programs, workshops, or training.
By clicking the box marked 'Yes' I acknowledge that I understand that the Colorado Public Records Law may require that certain information contained on this application be accessible to the general public, except when specifically made confidential by statute.
By clicking the box marked 'Yes' I acknowledge that I understand my appointment will begin January 1, 2019.
I do hereby certify that to the best of my knowledge and belief the information contained herein is true and correct, and that I have fully disclosed any personal or business interests in matters before the board or commission for which I am applying.
This field is not part of the form submission.
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