BOARD MEMBERS  

Jay Hight, D.V.M.
President

John Burger
1st Vice President

Donald Becker
2nd Vice President

Mel Berti
Clarence Bugenig
Ken Christen
Al Cooper
Valerie Davis
Jeff Farley
Sandy Hanks
Darren Hansen
Travis Low
Eugene Lucas
Jack Macdonald
Dave Mogni
Cindy Olsen
Robert Prior
Tim Renner
Johanna Rodoni
Wayne Wilson

Stuart Titus
General Manager

Employment Application

Date                _______________________

Name              _______________________________________________

Address         _______________________________________________

City                 _________________________ Zip____________________

Birthdate       _________________________ Age___________________

Phone            (________)_______________________________________

E-mail            ________________________________________________

Social Security Number  ____________ - ____________ - ___________

Reference      _______________________________________________

            Phone              (________) ________________________________

Type of work sought: ________________________________________

___________________________________________________________

___________________________________________________________

Additional Information: _______________________________________

___________________________________________________________

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1250 - 5th Street • Ferndale, CA 95536
email: humcofair@frontiernet.net • www.humboldtcountyfair.org
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707.786.9511 ~ 707.725.1306 (Phone) • 707.786.9450 (Fax)