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Town of Wickenburg
155 N. Tegner St. Suite A
Wickenburg, AZ 85390
CITIZEN APPLICATION FORM Phone: 628-604-6451
TO SERVE ON A COMMISSION, COMMITTEE OR BOARD www.wickenburgaz.gov
POSITION APPLYING FOR (All Applicants must live in the Town limits):
Please only apply for one board/committee/commission, your top area of interest.
© Board of Adjustment (Meets as needed on a Thursday at 5:30 PM)
& Community Programming Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
D Economic Development and Transportation Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
C Parks and Trails Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
O Planning & Zoning Advisory Commission (Meets monthly on the last Thursday at 5:30 PM)
O Public Safety Retirement Boards (Meets 2 times per year)
Name: Eberhardt Terry
Last First
Street
Wickenburg Arizon i. 253410
State Zip Code
Phone: Type of Phone: Home Work Cell X
Email:
How jong have you lived in the Town of Wickenburg?, 7 months
Are you a registered voter in Wickenburg? = YES o NO
Please ond to all questions, attach a separate sheet of paper if necessary.
1) | am interested in serving and/or am qualified to serve on the Committee because:
| have always given back to the communities | have resided in and wish to do so here
as well. | have almost 50 years of experience in community service especially in the
area of recreation programs. Recreation opportunities are critical in serving the
residents of our city and | hope to assist in this as much as I can.
2) What motivated you to apply for this specific committee?
Being a new member of this city, | have always thought it important to give back to the
communities | have resided in. As 1 have estensive experience in recreation
progaming and services, serving on this committee made the most sense.
3) What do vou see as the vision for the committee?
To assist staff in short and long term programming decisions by giving them our ideas
on ideal programs that meet the needs and interests of our residents.
4)
5)
What brought you to Wickenburg? What other organizations in Wickenburg do you volunteer at?
We made the dificult decision to leave our home in California and fell in love with the
town of Wickenburg and alll it offers. We are very happy here and are enjoying ail this
area has to offer
is there any additional information that you think would be helpful for the Council to know when
making a selection for members?
Over the years during my professional career and retirement years, | have served on or provided staff
support to many Boards, commissiions and committees. To name a few, it included providing staff
support to the City of San Jose Senior Commission for 11 years, serving on the Santa Clara County
Socal Services Commission, San Luis Obispo Parks Commission and Bear River Parks and Recreation
District Board and the Lake of Pines Association Board.
Please attach a resume with related previous experience (if available).
Please initial the questions below with your acknowledgement and understanding.
ee
TE
TE
TE
\f you miss three consecutive meetings, or three meetings within a six-month period, you may
be removed from office.
Ail members must maintain Wickenburg residency in order to remain in office.
Committing a felony or certain crimes will automatically remove you from office.
If you are no longer able or willing to serve, please contact your board chair and staff liaison.
Ct SIGNATURE DATE
For questions or to submit forms please send to:
Amy Brown, Town Clerk at (928) 668-0517 or abrown@wickenburgaz.gov
OFFICE USE ONLY — Revision March 2023
Date Application Received Al3leBse
Applicant Notified Date
Date Of Council Appointment
Date Of Term Expiration
Comments:
Applications will be kept on file for one year.
Most of our terms expire in December on a staggered basis.
Most terms are for two-years.
RESUME
TERRY J. EBERHARDT
EDUCATION
1970 -
1972 .
1979 -
EXPERIENCE
May 1996 - October 2001
September 1994- April 1996
September 1980 - August 1994
December 1976 - August 1980
September 1972 - November 1976
June 1972 - August 1972
December 1970 - May 1972
1966 - 1970
A.A. with Concentration in American Studies
Foothill College, Los Altos, CA
B.S. Recreation
San Jose State University, San Jose, CA
Completed Management Course provided by the City of San
Jose through Santa Clara University
City of San Jose
Department of Parks, Recreation and Neighborhood Services
San Jose, CA
Deputy Director, Recreation and Community Services Division
City of San Jose
Department of Parks, Recreation and Community Services
San Jose, CA
Recreation Superintendent, Office on Aging and Office of
Therapeutic Services
City of San Jose
Department of Parks, Recreation and Neighborhood Services
San Jose, CA
Recreation Superintendent
City of San Jose
San Jose Parks and Recreation Department, San Jose, CA
Principal Recreation Supervisor
City of San Jose
San Jose Parks and Recreation Department, San Jose, CA
Neighborhood Recreation Supervisor
Redwood City Parks and Recreation Department
Redwood City, CA
Internship in Recreation
City of San Jose
San Jose Parks and Recreation Department, San Jose, CA
Recreation Leader
U.S.A.F. - Communication Specialist
TERRY EBERHARDT
BIO
I was born and raised in Los Altos, California. After high school, I attended Foothill College for two
years before enlisting in the United States Air Force in 1966. I served in the Air Force for four years,
1966-1970, and was honorably discharged. I then attended San Jose State University and majored in
Recreation.
I graduated from San Jose State University with a major in Recreation and Leisure Studies in 1972. I
completed my Recreation Internship at the City of Redwood City, CA. In 2000, I was selected as San
Jose State University Alumni of the year for Recreation and Leisure Studies.
I spent thirty years with the City of San Jose Parks and Recreation Department retiring as Deputy Director
in 2001. I was responsible for the Recreation and Human Services Division of the department, which
provided an extensive program of services and activities for all ages to the nearly 1 million San Jose
residents. While in city service, I served eight years on the Santa Clara County Social Services
Commission, chairing two years and served as the first chairman of the Valley Transit Agency Committee
on Transit Accessibility in 1996.
After retirement in 2001, my wife Cindie and I relocated to the California Central Coast to live in Avila
Beach (near Pismo Beach). Once there, I began to volunteer in the community.
I served as President and Vice President on the Board of Directors of the Avila Beach Civic Association
and chaired the building committee for ABCA. The ABCA is a local non-profit agency that provides
services and advocacy for the Avila Beach area. The ABCA completed a major renovation of its Avila
Beach Community Center in 2007. I led the fund raising process which raised the needed $1,400,000 for
the project and acted as construction Project Manager. I served as volunteer Executive Director for two
years and led the program development phase for the Board. In cooperation with a new program
coordinator, we implemented a new and expanded recreation program. I served as President of our Home
Owners Association for two years.
I also served as a Parks and Recreation Commissioner for San Luis Obispo County for four years. During
my tenure on the San Luis Obispo County Parks and Recreation Commission, the commission worked on
the adoption of a county wide Parks Master plan which was adopted by the County Board of Supervisors.
I also chaired the Avila Beach Parking Task Force (at the direction of the County Supervisor) for two
years that worked on parking issues in Avila Beach. In addition, I served on the Avila Valley Advisory
Council which advises the County Board of Supervisors on issues affecting the greater Avila area.
My wife Cindie and I relocated to Lake of the Pines, in Northern California in May of 2012. I enjoy
playing golf, tennis, traveling and have a deep interest in all things related to wine. I served on the LOP
Environmental Control Committee (chair in 2015) and served as chair of the LOP Recreation Committee
until January, 2015. I also chaired the Pickleball Facility Development Ad Hoc Committee in 2015. I
was a member of the LOP SIRS and LOP Men’s Golf Club. I served on the LOP Board of Directors for
three years and as President for one year, and chaired the Long Range Strategic Plan Ad Hoc Committee.
I also served on the Board of Directors of the Bear River Recreation and Parks District.
We relocated to Wickenburg at Wickenburg Ranch in July 2024.
1/31/25
Town of Wickenburg
155 N. Tegner St. Suite A
Wickenburg, AZ 85390
CITIZEN APPLICATION FORM Phone: 928-684-5451
FAX: 602-506-1580
TO SERVE ON A COMMISSION, COMMITTEE OR BOARD www.wickenburgaz.gov
POSITION APPLYING FOR (All Applicants must live in the Town limits):
Please only apply for one board/committee/commission, your top area of interest.
O Board of Adjustment (Meets as needed on a Thursday at 5:30 PM)
UO Community Programming Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
& Economic Development and Transportation Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
0 Parks and Trails Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
0 Planning & Zoning Advisory Commission (Meets monthly on the last Thursday at 5:30 PM)
O Public Safety Retirement Boards (Meets 2 times per year)
Name: Hamilton Stephen
Last First
Residence Address:
In Town of Wickenburg town limits
Mailing — ll
Wickenburg Arona 85390
Ci
coi lll
State Zip Code
Phone: Type of Phone: Home Work
Email:
93.5 years
How long have you lived in the Town of Wickenburg
Are you a registered voter in Wickenburg? = YES o NO
Please respond to all questions, attach a separate sheet of paper if necessary.
1) | am interested in serving and/or am qualified to serve on the Committee because:
As a former independent business owner | have a deep interest in the business growth within our
community. In addition, | spent nearly 60 years of my life in the Travel and Tourism Industry having
worked for an airline, regional manager for a large vacation focused travel agency (oversight of 75+
travel agencies across three state regions, large payroll and advertising budget control etc.) and before
retirement owned and operated one of the largest cruise only travel agencies in the Rocky Mtn. region
located in Denver, Co.
2) What motivated you to apply for this specific committee?
Business and tourism aspect of the committee.
3) What do you see as the vision for the committee?
Wickenburg is a somewhat hidden gem for day and weekend trips away from larger population areas.
We need to expand the reach of promotion about what this community has to offer beyond what is
being done by Chamber or local business efforts. Our winter months are full of tourism opportunity from
ongoing daily and weekly western rodeo type events to 4 wheeling into desert and a large variety of
available sports activites. End result is a pro business effort. Both areas are a focus of this committee.
4) What brought you to Wickenburg? What other organizations in Wickenburg do you volunteer at?
We had been living in North Central Phoenix and wanted to slow our lives down a bit
and Wickenburg and specifically Wickenburg Ranch checked all the quality of live
boxes on our list of wants and desires.
5) Is there any additional information that you think would be helpful for the Council to know when
making a selection for members?
Provide exceptional OJT and Management experience. | have been President of a
local club(Denver location) of an International tourism organization. President on the
board of a regional travel consortium based in Phoenix. President on boards of two
different Homeowner Associations - one in Phoenix and one in Kansas City, Missouri.
Now retired with time to assist.
Please attach a resume with related previous experience (if available).
Please initial the questions below with your acknowledgement and understanding.
SPH___ If you miss three consecutive meetings, or three meetings within a six-month period, you may
be removed from office.
SPH __ All members must maintain Wickenburg residency in order to remain in office.
SPH _ Committing a felony or certain\crimes will automatically remove you from office.
SPH ___ If you are no longer able-er willingitd serve, please contact your board chair and staff liaison.
January 22, 2025
SIGNATURE “NX DATE
For questions or to submit forms please send to:
Amy Brown, Town Clerk at (928) 668-0517 or abrown@wickenburgaz.gov
OFFICE USE ONLY — Revision March 2023
Date Application Received 01/22/2025
Applicant Notified Date
Date Of Council Appointment
Date Of Term Expiration
Comments:
Applications will be kept on file for one year.
Most of our terms expire in December on a staggered basis.
Most terms are for two-years.
es Town of Wickenburg
a 155 N. Tegner St. Suite A
Town of Wickenburg Wickenburg, AZ 85390
CITIZEN APPLICATION FORM ac tess coe ased
TO SERVE ON A COMMISSION, COMMITTEE OR BOARD www.wickenburgaz.gov
POSITION APPLYING FOR {All Applicants must live in the Town limits):
Please only apply for one board/committee/commission, your top area of interest.
Board of Adjustment (Meets as needed on a Thursday at 5:30 PM)
Community Programming Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
B Economic Development and Transportation Advisory Committee (Meets every other month on a Wednesday at 4.00 PM)
Parks and Trails Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
Planning & Zoning Advisory Commission (Meets monthly on the last Thursday at 5.30 PM)
Public Safety Retirement Boards (Meets 2 times per year)
Mortimer Karla
Last First
Name:
Residence Address:
In Town of Wickenburg town limits
Mailing Address:
Wickenburg we a 85390
City State Zip Code
Phone Type of Phone: Home Work Cell x
11 years
How long have you lived in the Town of Wickenburg?.
Are you a registered voter in Wickenburg? = YES NO
Please respond to all questions, attach a separate sheet of paper if necessary.
1) | am interested in serving and/or am qualified to serve on the Committee because:
| am very interested and invested in the Wickenburg Community. The economic
development of this community can make an impact on our businesses.
2) What motivated you to apply for this specific committee?
As a business owner this committee holds a high importance to me as well as a
resident of the Wickenburg community.
3) What do you see as the vision for the committee?
Economic and social change that may be part of growth in Wickenburg.
4) What brought you to Wickenburg? What other organizations in Wickenburg do you volunteer at?
My family is a roping family and has visited Wickenburg since my father was young.
My parents retired to Wickenburg about 15 years ago. We would visit them often
which naturally made us fall in love with Wickenburg to raise our son. We enjoy the
small town feel.
| have volunteer for the AYSO Board, Chamber Board, FSL, St Anthony of Padua,
Eraadam Evnrace Wirkanhiura Chrictian Aradamy Cawnirl lIn Raard Darke and Rar
5) Is there any additional information that you think would be helpful for the Council to know when
making a selection for members?
| am Wickenburg from the heart, | enjoy this town, | love volunteering, | simply love my
community.
Please attach a resume with related previous experience (if available).
Please initial the questions below with your acknowledgement and understanding.
kM If you miss three consecutive meetings, or three meetings within a six-month period, you may
be removed from office.
KM All members must maintain Wickenburg residency in order to remain in office.
KM Committing a felony or certain crimes will automatically remove you from office.
kM If you are no longer able or willing to serve, please contact your board chair and staff liaison.
14/21/2024
DATE
For questions or t bmit forms please send to:
Amy Brown, Town Clerk at (928) 668-0517 or abrown@wickenburgaz.gov
OFFICE USE ONLY — Revision March 2023
Date Application Received Nla2if27
Applicant Notified Date af
Date Of Council Appointment
Date Of Term Expiration
Comments:
Applications will be kept on file for one year.
Most of our terms expire in December on a staggered basis.
Most terms are for two-years.
Town of Wickenburg
155 N. Tegner St. Suite A
Wickenburg, AZ 85390
CITIZEN APPLICATION FORM sane eee
TO SERVE ON A COMMISSION, COMMITTEE OR BOARD www.wickenburgaz.gov
POSITION APPLYING FOR (All Applicants must live in the Town limits):
Please only apply for one board/committee/commission, your top area of interest.
0 Board of Adjustment (Meets as needed on a Thursday at 5:30 PM)
0 Community Programming Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
® Economic Development and Transportation Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
0 Parks and Trails Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
O Planning & Zoning Advisory Commission (Meets monthly on the last Thursday at 5:30 PM)
O Public Safety Retirement Boards (Meets 2 times per year)
Barringer Vincent
Last First
Name:
Wickenburg he Strest 85390
Phone Type of Phone: Home Work Cell Xx
Email:
3.5 years
How long have you lived in the Town of Wickenburg?.
Are you a registered voter in Wickenburg? = YES nm NO
Please respond to all questions, attach a separate sheet of paper if necessary.
1) | am interested in serving and/or am qualified to serve on the Committee because:
| am interested and qualified to serve on this committee because of my over thirty
years of experience in all aspects of logistics, including warehousing, delivery, and
OTR trucking.
2) What motivated you to apply for this specific committee?
| am motivated to seek this position because with the new rail road distribution hub
being built in Wittman, Wickenburg will be strongly affected. | thought | would be able
to use my expertise to see ail sides of any issue and be able to come up with solutions
that would be beneficial to all parties.
3) What do you see as the vision for the committee?
To find solutions that are equitable not only to the concerned commercial interests, but
for the citizens of Wickenburg as well.
4) What brought you to Wickenburg? What other organizations in Wickenburg do you volunteer at?
| came to Wickenburg to serve as Pastor at Redeemer Lutheran Church. | volunteer
at the Lions Club, Salvation Army, as well as the congregation | am serving.
5) ts there any additional information that you think would be helpful for the Council to know when
making a setection for members?
That after fifteen years as a pastor, | know how to get my opinion across in a meeting
without grandstanding or being disagreeable to those that | disagree with
Please attach a resume with related previous experience (if available).
Please initial the questions below with your acknowledgement and understanding.
vb If you miss three consecutive meetings, or three meetings within a six-month period, you may
be removed from office.
vo All members must maintain Wickenburg residency in order to remain in office.
vb Committing a felony or certain crimes will automatically remove you from office.
vo If you are no longer able or willing to serve, please contact your board chair and staff liaison.
Fea
ey PP ARIOOD virile 02/03/25 y~(- Jor
“Uy SIGNATURE = DATE
For questions or to submit forms please send to:
Amy Brown, Town Clerk at (928) 668-0517 or abrown@wickenburgaz.gov
OFFICE USE ONLY — Revision March 2023
Date Application Received aly/2s
Applicant Notified Date
Date Of Council Appointment
Date Of Term Expiration
| Comments:
Applications will be kept on file for one year.
Most of our terms expire in December on a staggered basis.
Most terms are for two-years.
Town of Wickenburg
155 N. Tegner St. Suite A
Wickenburg, AZ 85390
CITIZEN APPLICATION FORM ieeeaecaeet
TO SERVE ON A COMMISSION, COMMITTEE OR BOARD :
www.wickenburgaz.gov
POSITION APPLYING FOR (All Applicants must five in the Town limits):
Please only apply for one board/committee/commission, your top area of interest.
© Board of Adjustment (Meets as needed on a Thursday at 5:30 PM)
(© Community Programming Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
$s Economic Development and Transportation Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
€ Parks and Trails Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
0 Planning & Zoning Advisory Commission (Meets monthly on the last Thursday at 5:30 PM)
Ci Public Safety Retirement Boards (Meets 2 times per year)
Name: Crutchfield Milt
Last
Residence Address:
in Town of Wickenburg town limi
Mailing .._ ZZ =
Wickenburg az nie 85390
Cit State Zip Code
Type of Phone: Home Work Cell X
How long have you lived in the Town of Wickenburg? 2") years
Are you a registered voter in Wickenburg? = YES n NO
Please respond to all questions, attach a separate sheet of paper if necessary.
1) | am interested in serving and/or am qualified to serve on the Committee because:
| am writing to express my interest in serving as a member of the Economic
Development and Transportation Committee. As a seasoned telecommunications
engineer with 40 years of professional experience, | bring a unique perspective that
bridges technology, infrastructure, and community development.
2) What motivated you to apply for this specific committee?
Having recently retired, | am looking to take on new challenges and find a renewed sense of purpose
by contributing to the community. This opportunity aligns with my interest in supporting initiatives that
promote smart economic growth and improve transportation systems.
1 am prepared to draw on my experience and skills to make a meaningful contribution to these efforts
and support the development of a stronger, more efficient community.
3) What do you see as the vision for the committee?
My vision for the Economic Development and Transportation Committee is to preserve the charm,
character, and rich western culture of our small-town community while planning for smart economic
growth. It is crucial to maintain the unique aspects that make our town special, such as its close-knit
atmosphere, rural character, and deep connection to western traditions, while also ensuring that we are
strategically prepared for future challenges and opportunities.
4) What brought you to Wickenburg? What other organizations in Wickenburg do you volunteer at?
We moved our family from Oregon to Arizona because we no longer felt connected to
the community there, as it no longer reflected our values and priorities. Wickenburg
appealed to us with its welcoming atmosphere and alignment with the kind of
community we were seeking. It offered the right environment for us to build a life that
better matches our goals and values.
5) Is there any additional information that you think would be helpful for the Council to know when
making a selection for members?
| am recently retired, an avid outdoorsman, and a power sports enthusiast. | value a
self-reliant lifestyle and enjoy exploring the areas natural beauty. These interests have
strengthened my connection to the community, and | am eager to contribute to its
smart and responsible growth.
Please attach a resume with related previous experience (if available).
Please initial the questions below with your acknowledgement and understanding.
if you miss three consecutive meetings, or three meetings within a six-month period, you may
be yemoved from office.
LAT members must maintain Wickenburg residency in order to remain in office.
ommitting a felony or certain crimes will automatically remove you from office.
you are no longer able or willing to serve, please contact your board chair and staff liaison.
itt ages rel d [22-26
SIG pe DATE
For questions or to submitforms please send to:
Amy Brown, Town Clerk at (928) 668-0517 or abrown@wickenburgaz.gov
OFFICE USE ONLY — Revision March 2023
Date Application Received VJ9 2/22 $
Applicant Notified Date , i
Date Of Council Appointment
Date Of Term Expiration
Comments:
Applications will be kept on file for one year.
Most of our terms expire in December on a staggered basis.
Most terms are for two-years.
Town of Wickenburg
155 N. Tegner St. Suite A
Wickenburg, AZ 85390
CITIZEN APPLICATION FORM Phone: 928-684-5451
TO SERVE ON A COMMISSION, COMMITTEE OR BOARD www.wickenburgaz.gov
POSITION APPLYING FOR (All Applicants must live in the Town limits):
Please only apply for one board/committee/commission, your top area of interest.
Board of Adjustment (Meets as needed on a Thursday at 5:30 PM)
Community Programming Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
Economic Development and Transportation Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
B Parks and Trails Advisory Committee (Meets every other month on a Wednesday at 4:00 PM)
Planning & Zoning Advisory Commission (Meets monthly on the last Thursday at 5:30 PM)
Public Safety Retirement Boards (Meets 2 times per year)
Wayne Coates
Last First
Name:
Residence Address:
In Town of Wickenburg town limits
Mailing — lUlUlhmUmwmm...sSY
Wickenburg a2 nie 85390
City State Zip Code
Phone: PF Type of Phone: Home || Work Cell iz
Email:
How long have you lived in the Town of Wickenburg? 6 months
Are you a registered voter in Wickenburg? = YES NO
Please respond to all questions, attach a separate sheet of paper if necessary.
1) | am interested in serving and/or am qualified to serve on the Committee because:
| am a trail runner and have worked on trails in Arizona and Colorado
2) What motivated you to apply for this specific committee?
Interested in developing more trails and helping to plan trail running events
3) What do you see as the vision for the committee?
Develop more trails and promote them
4) What brought you to Wickenburg? What other organizations in Wickenburg do you volunteer at?
Moved so my wife could be closer to here family in Sun City West
5) Is there any additional information that you think would be helpful for the Council to know when
making a selection for members?
Please attach a resume with related previous experience (if available).
Please initial the questions below with your acknowledgement and understanding.
wee If you miss three consecutive meetings, or three meetings within a six-month period, you may
be removed from office.
wec All members must maintain Wickenburg residency in order to remain in office.
wee Committing a felony or certain crimes will automatically remove you from office.
wee If you are no longer able or willing to serve, please contact your board chair and staff liaison.
January 15, 2025
SIGNATURE DATE
For questions or to submit forms please send to:
Amy Brown, Town Clerk at (928) 668-0517 or abrown@wickenburgaz.gov
OFFICE USE ONLY - Revision March 2023
Date Application Received Lf /s Jas”
Applicant Notified Date -
Date Of Council Appointment
Date Of Term Expiration
Comments
Applications will be kept on file for one year.
Most of our terms expire in December on a staggered basis.
Most terms are for two-years.
5 155 N. Tegner St. Suite A
Town of Wickenburg Wickenburg, AZ 85390
CITIZEN APPLICATION FORM Phone 928-684-5451
FAX. 602-506-1580
TO SERVE ON A COMMISSION, COMMITTEE OR BOARD www.wickenburgaz.gov
POSITION APPLYING FOR {All Applicants must live in the Town limits):
Please only apply for one board/committee/commission, your top area of interest.
Board of Adjustment (Meets as needed on a Thursday at 5 30 PM)
Community Programming Advisory Committee (Meets every other month on a Wednesday at 4 00 PM)
Economic Development and Transportation Advisory Committee (Meets every other month on a Wednesday at 4 00 PM)
Parks and Trails Advisory Committee (Meets every other month on a Wednesday at 4 00 PM)
% Planning & Zoning Advisory Commission (Meets monthly on the last Thursday at 5 30 PM)
Public Safety Retirement Boards (Meets 2 times per year)
Name: Cotsles ( L/
eet
Last First
Residence Address:
Mm TOW OL VVICKEDDUro Low Hirt
AZ
State
Mailing Address:
&ELILD
Zip Code
Phone: ;
ype of Phone: Home Work Cell_C7”
Email:
f
How long have you lived in the Town of Wickenburg? owe LA 7 a
Are you a registered voter in Wickenburg? ey NO
Please respond to all questions, attach a separate sheet of paper if necessary.
1) | am interested in serving and/or am qualified to serve on the Committee because:
3Y YoR Om Comm ise le
Plapere, ~ZOrs
2) What motivated you to apply for this specific committee?
To Su lhe Irinkve, Gww bol book
3) What do you see as the vision for the committee?
Tov Poop Happy Te Live Here
4) What brought you to Wickenburg? What other organizations in Wickenburg do you volunteer at?
C linge
5) Is there any additional information that you think would be helpful for the Council to know when
making a selection for members?
Please attach a resume with related previous experience (if available).
Please initial the questions below with your acknowledgement and understanding.
if you miss three consecutive meetings, or three meetings within a six-month period, you may
be removed from office.
&/C._ Allmembers must maintain Wickenburg residency in order to remain in office.
tC. Committing a felony or certain crimes will automatically remove you from office.
£7C_ \f you are no longer able or willing to serve, please contact your board chair and staff liaison.
7 VA Wh (246124
7 SIGNATURE DATE ‘
For questions or to submit forms please send to:
Amy Brown, Town Clerk at (928) 668-0517 or abrown@wickenburgaz.gov
OFFICE USE ONLY - Revision March 2023
Date Application Received tH te2LS
Applicant Notified Date ,
Date Of Council Appointment
Date Of Term Expiration
Comments:
Applications will be kept on file for one year.
Most of our terms expire in December on a staggered basis.
Most terms are for two-years.