State of Colorado Boards and Commissions Application

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Applicant Information









Contact Information












District Information




Voter Information


Education
High School





College
College 1






College 2






Graduate School











Employment








References
Reference 1



Reference 2



Reference 3



Additional Questions






Electronic Signature

I certify that the facts contained in this application are true and correct to the best of my knowledge.  I authorize investigation of all statements contained herein and the references listed above to obtain any and all pertinent information, personal and otherwise.  I further authorize the Office of the Governor to conduct a criminal background check, including requesting a criminal history from the Colorado Bureau of Investigation.  If I am a Colorado licensed lawyer, I waive any confidentiality provided by C.R.C.P. 251.31 regarding pending disciplinary proceedings and grant permission to contact the Office of Attorney Regulation to investigate for any history of misconduct, including matters at both the intake and formal proceeding stage. I release all parties for all liability for any damage that may result from furnishing such information.


By signing below, I agree that all information is correct and release the Office of the Governor to conduct necessary background checks.



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