Kōmike Aʻoaʻo Kōkua Hoʻonāʻo 3 Pūnaewele

inoa*

Ka mua hope

Address*

Street Address Nānā Laina 2 manaʻo Moku'āina Helu kuhi

County*

enamel*

Phone*

Ka nānā a me kaʻike*

Pono mākou e ka moku'āina e loaʻa nā manaʻo likeʻole a me nāʻike i hōʻikeʻia ma kēia komite. Eʻoluʻolu e nānā i nā mea a pau e pili ana iāʻoe:

Kau i ka Limahana / Hana*

No ke ahaʻoe e makemake ai e komo i ka PIAC āpana?*

He aha nāʻano pilikino mālama iāʻoe a no ke aha?*

He aha nā kuʻuna, kaʻike, a me ke hiʻohiʻona āu i manaʻo ai e hiki iāʻoe ke mahele?*

Inā he lālā ʻoe, lālā o ka ʻohana a me / a mea lawelawe paha, pehea kou manaʻo e hōʻike ana ʻoe i ka ʻokoʻa o ka lālā ʻo Health First Colorado? (Inā pili ʻole kēia iā ʻoe, e ʻoluʻolu e kākau "ʻaʻole pili")*

Pehea ʻoe i lohe ai e pili ana i ke komite aʻoaʻo aʻoaʻo hoʻomaikaʻi hou (PIAC) o kēia ʻāina?*

ʻIkeʻikeʻike

ʻO ka paneʻana i kēia mea he koho, akā ua hoʻoikaikaʻia. E noʻonoʻoʻia kaʻike i ka wā e koho ai mākou i nā lālā o ke kōmike ma ka manaʻo maikaʻi e ho'āʻo i ka hoʻohālikelike likeʻana mai nā wahi o nā kaiāulu.

hoohanau

Ethnicity

palapala hoʻomaikaʻi*

Ke hōʻike nei au i ka pololei a me ka pololei o nā mea i loko o kēia palapala noi i ka maikaʻi o kaʻuʻike. Uaʻike hou au e hiki i ka Colorado Open Records Act ke koi aku i kekahi mauʻike i loko o kēia noi e hiki ai ke nānāʻia e ka lehulehu. E hōʻoia ma ka nānāʻana i ka pahu ma lalo nei:

ʻAe

Kōmike Aʻoaʻo Kōkua Hoʻonāʻauaoʻo Kōnae 3

ʻO Adams, Arapahoe, Douglas & Elbert mau helu

Māhele 3 PIAC