Komiti Yolangizira Mapulani a Pulogalamu ya 5

dzina*

Choyamba Pomaliza

Address*

Adilesi yamsewu Mzere wa Mauthenga 2 maganizo State Zipi Kodi

County*

Email*

Phone*

Zochita ndi Zochitika*

Timafunikira kuti boma likhale ndi malingaliro osiyanasiyana ndi zomwe zikuyimira pa komiti iyi. Chonde onani zonse zomwe zikukukhudzani:

Wogwira Ntchito / Ntchito*

Nchifukwa chiyani mukufuna kutenga nawo mbali pa Regional PIAC?*

Kodi ndi zinthu ziti zofunika paumoyo zomwe zili zofunika kwa inu ndipo chifukwa chiyani?*

Ndi luso liti, chidziwitso, ndi malingaliro omwe mukuganiza kuti mukhoza kugawana nawo?*

Ngati ndinu membala, wachibale komanso / kapena wosamalira, mukumva bwanji kuti mukuyimira mitundu ya mamembala a Health First Colorado? (Ngati izi sizikukhudzani, chonde lembani "sizikugwira ntchito")*

Munamva bwanji za Dipatimenti Yowonjezera Mapulogalamu a Kupititsa patsogolo Pulogalamu (PIAC)?*

Chiwerengero cha Anthu

Yankho la zotsatirazi ndilofuna, koma limalimbikitsidwa. Chidziwitsocho chidzaganiziridwa tikasankha mamembala a komiti mwachikhulupiriro ndikuyesera kukhala ndi chifaniziro chofanana kuchokera kumadera onse a anthu.

Gender

Chikhalidwe

chitsimikizo*

Ndikutsimikizira kuti zowona zomwe zili muzowonjezerazi ndizoona ndikukonzekera zabwino zanga. Ndikumvetsetsa kuti Colorado Open Records Act ingafune kuti mauthenga ena omwe ali mu polojekitiyi akhalepo kuti ayang'ane ndi anthu onse. Dziwitsani mwa kufufuza bokosi ili m'munsimu:

inde

Komiti Yowunikira Pulogalamu ya Pulogalamu ya 5

City & County of Denver

Chigawo 5 PIAC