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Producer Responsibility Program for Statewide Recycling Advisory Board Application
Please complete the application below in its entirety. If you are unable to fill out this form, please email Mellik Gordan, Producer Responsibility Lead at
EPRcomments@state.co.us
.
Contact information
Last name
First name
Home county
Home address
City
State
Zip code
Personal/cell phone
Preferred email
Confirm email
Curent employer
Business phone
Business county
Business address
Business city
Business state
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
VI
WA
WV
WI
WY
Business zip
Do you want to list any memberships, offices held,
or volunteer work you have participated in?
Yes
No
Please indicate the number of items you would like to include.
1
2
3
4
5
6
7
8
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