Boards and Commissions Application

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Select Board or Commission

Applicant Name

Occupation

Applicant Email

Applicant Phone (daytime or cell)

Applicant Physical Address

Physical Address Line 2

City

State

ZIP/Postal Code

Communities to Represent

Additional Communities?

Enter Additional Communities

List any marijuana establishments located in Pueblo County that you own, are employed by, represent, or are otherwise affiliated with; and explain the nature of your relationship with each establishment:

For each establishment listed above, describe the size of the operation and list the number of people employed by the establishment:

List any marijuana establishments located outside of Pueblo County that you own, that you are employed by, or that you represent or are otherwise affiliated with, and explain the nature of your relationship with that establishment:

This work group will consist of one representative per each of the following categories of license, as well as three general community representative. Please indicate which of the positions you are applying for:

Retail Marijuana Cultivation Facility Representative

Medical Marijuana Optional Premises Cultivation Facility Representative

Medical or Retail Infused Product Manufacturing Facility Representative

Retail Marijuana Store Representative

Medical Marijuana Center Representative

General Community Representative

What is the basis of your qualifications?

Why are you interested in being appointed to this work group or commission?

List any other items that might be useful in consideration for your appointment to this work group:

List any other civic or community commissions, boards or committees on which you currently serve:

List any financial, budget, or management background:

Media Source

Other Media (if selected)

Resume

Please attach your resume or other pertinent information.
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We're still conducting business under revised guidelines. No IN PERSON services are available. Click Here for recent changes to the in person services and how to access services online

For COVID-19 information please visit the Pueblo Health Department page Click Here

For COVID-19 information please visit the Pueblo Health Department page Click Here

Please Click Here to take the COVID-19 Business Survey

Boards and Commissions Application

We're still conducting business under revised guidelines. No IN PERSON services are available. Click Here for recent changes to the in person services and how to access services online For COVID-19 information please visit the Pueblo Health Department page Click Here

For COVID-19 information please visit the Pueblo Health Department page Click Here

Please Click Here to take the COVID-19 Business Survey

Boards and Commissions Application

We're still conducting business under revised guidelines. No IN PERSON services are available. Click Here for recent changes to the in person services and how to access services online

For COVID-19 information please visit the Pueblo Health Department page Click Here