Regular Fire Board Meeting - January 25, 2023

DATE: ________________

Board Candidate Application and Questionnaire

Name: ____________________________________________

Age: ________ (optional)

Residence Address: _________________________________________________________

Mailing Address: ________________________________________________

Telephone: _________________ (day time)

Telephone: _________________ (evening)

E-mail Address: ____________________________

Are you a registered voter within the District?

Yes ______

No ______

Duration of residency within the District: _____________________ (optional)

1.

Introduction:

2. Provide a description of your educational, work, and/or public service background.

3.

What do you hope to accomplish as a member of the Board of Directors?

4. What skills, abilities, and experience would you bring to the Board to assist in carrying out its responsibilities?

Posted on this 30 th day of January 2023 at 5:00 P.M. MST by: Mr. Marcarlo Roanhorse, Administrative Assistant