2. Last Name*
3. First Name*
4. Date*
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6. Email Address*
7. Home Phone:
8. Cell Phone:
10. Board / Commission:*
    -- Select One --Airport Advisory CommitteeBoard of ElectionsBoard of HealthBoard of WaterworksCivil Service CommissionCommunity Services Advisory CommissionCommunity Commission on Housing and HomelessnessEl Centro Del Quinto Sol Board of DirectorsElectric Utility CommissionEnergy Advisory CommissionFire Board of AppealsFiremen's Pension Fund Board of TrusteesFountain Creek Flood Control & Greenway Dist.Golf Course Enterprise Adv CommitteeHARP Authority Board of DirectorsHARP Foundation Board of DirectorsHonor Farm Enterprise Citizens Advisory BoardHousing Authority of the City of PuebloHuman Relations CommissionLibrary District Board of TrusteesLiquor & Beer Licensing BoardMarijuana Licensing AuthorityPolice Pension Board of TrusteesPueblo Area Council of GovernmentsPueblo Conservancy DistrictPueblo Depot Activity Dev. Authority BoardPueblo Economic Dev. Corporation BoardRegional Building CommissionSangre De Cristo Arts & Conference Ctr. BoardStreetscape Advisory CommitteePueblo Urban Renewal AuthorityZoning Board of AppealsOther
11. Other*
13. .*

    1. I certify by checking this box I will watch the following training video in its entirety.
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