BOARD MEMBERS  

Valerie Davis
President

Jay Hight, D.V.M.
1st Vice President

John Burger
2nd Vice President

Donald Becker
Bill Branstette
Clarence Bugenig
Ken Christen
Al Cooper
Jeff Farley
Donald Giacomin
Sandy Hanks
Travis Low
Eugene Lucas
Jack Macdonald
Cindy Olsen
Irv Parlato
Herbert Peterson Jr.
Robert Prior
Tim Renner
Johanna Rodoni
Wayne Wilson

Stuart Titus
General Manager

Employment Application

Date                _______________________

Name              _______________________________________________

Address         _______________________________________________

City                 _________________________ Zip____________________

Birthdate       _________________________ Age___________________

Phone            (________)_______________________________________

Social Security Number  ____________ - ____________ - ___________

Reference      _______________________________________________

            Phone              (________) ________________________________

Type of work sought: ________________________________________

___________________________________________________________

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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)