BOARDS AND COMMISSIONS APPLICATION
Please complete the following information in full,
attach a cover letter, current resume or biography and return to the address below.
Type or print in blue or black ink.
Board or Commission you are applying for:____________________________________________
Last Name: ____________________________ First Name: ____________________________
Occupation/Employer: __________________________________________________________
Work Address: ________________________________ City: ____________Zip: ___________
Work E-mail Address: ________________________________ __________________________
Work Phone: __________________________ Work/Home Fax: _________________________
Home Address:___________________________ City: _________________ Zip: ___________
Home Phone: ____________________________ Cell Phone/ Pager: ______________________
Home E-mail Address: __________________________________________________________
Are you a registered voter? Yes No If so, what county? ________________________
Denver City Council District No.: __________ Ethnicity___________________________
Highest Level of Education or Degree Earned: ___________________ Year Completed: ______
Memberships/ Organizations/ Volunteer Activities (include past or present):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
References (List three persons, not related to you, whom you have known at least one year):
Name Address Phone Number
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Special Information:
Is there anything that would adversely affect public confidence in your appointment or service? Yes No
If yes, please explain on a separate sheet of paper.
_______________________________________
Signature Date
Return Completed Form to:
Anthony Aragon, Director of Boards and Commissions
City and County of Denver Building, Room 350
Denver, CO 80202 Phone: (720) 865-9032 Fax: (720) 865-8787