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BOARD APPLICATION Nye County Administration 2100 Walt Williams Dr. Pahrump, NV 89048 (nq7sL-7o7s ,E rH Nur Ir !tl, sle *Env,'.on-.nfa I nL.) fht Board O n Date:J a-3 aDDllan iErI: I I (her,l \/arl&lrs ?ih**o ,rlV Zbl 810,1v {d,o rnJole 5t rb;€ Addr€{s: Ot$ tr Sbte: I t 4. So l"ng (l OtherTehphorI€: [PHONE REDACTED] E-mail address: Olrerv ]va rKa l,s @Y e ri a' n, n n7 Hqrn f.hDhqi.: rJn it ye3, rhkh DeprrEn.it: I h.ve.!bd€d rny r?!ur'I/ktt ? ol lnE tst: rc tr ffp*d"t*o'*-"*' trl vou c vcs E Please provide a brief description of your qualifications, experience, or interests that would be considered an asset to this Board: I outti+ ,4 Ust PA, t/s DlPt, Nav A5 Ae funal e;vi ) 3E \ut c/-o (a a4. -O,n-tArr.at'a.a-t w J lxl;,ezt< c e- Y,Yk i(Zt, ubl d *ht- I certiry that I am a QUALIFIED ELECrOR, that I MEEI SrATUTORY REQUIRMENTS ofthe Board area to which I am appvin& and that the information is true and accurate to the best of my knowledge- tAt rril.l,L w"ti- The Boord to whidt you ore applying neets dt least ooce o ,nonth ond possiuy erenings- Y,t Mailor deliver completed form to Pahrump Toun Office 2100 E. Walt Williams Dr., Suite *100 Pahrump, NV 8!)048 (This document becomes a plblic reor9 Name oI Board: Ap9lkant afie: *5;;L \".l,llro-^ E r Jac bl' qlobt otE J Po-hr ur... IUevrdo- stite: 5833 E Pb.dla,,As An Home Address: State: ziP: MailingAddresr: t City: E-mailaddress: .1,h,^k^lle ri r*o llot' eo llrom€ T€lephom: J1q-53?-lO17 odlrr bxb- s83 -89b5 I haya attadEd my rla{nl.Eer of intertst: vcs I ro E lf yei, which O€parbnent: Arr yos clrrelth_c.i ves E noA ployed by ttye County: thisBoard: I- hu,t< i'^ST COrnpleTe4 a. 5lA Tl'y< be.ponTnenT ;f En