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Town of Wickenburg 155 N. Tegner St. Suite A Wickenburg, AZ 85390 CITIZEN APPLICATION FORM pore See eerss 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: Barringer Lisa Last Residence Address: In Town of Wickenburg town limits Mailing Address: Wickenburg az Steet 85390 City State Zip Code Phone! ype of Phone: Home Work Cell Xx Email: How long have you lived in the Town of Wickenburg?4 years 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 retiree with a law enforcement background of over 30 years. | have an understanding of the unique issues involved in public safety retirements. 2) What motivated you to apply for this specific committee? Retirement benefits are essential to recruitment and retention of qualified individuals for the rigiorous requirements of the public safety positions. 3) What do you see as the vision for the committee? Fair and transparent evaluations of and responses to the issues at hand. 4) What brought you to Wickenburg? What other organizations in Wickenburg do you volunteer at? My husband relocated to Wickenburg for work. | volunteer at the Wickenburg Community Hospital and am a member of the Wickenburg Lions club. | am also very active with Redeemer Lutheran Church and our monthly community events that fundraise for local organizations and causes. 5) Is there any additional information that you think would be helpful for the Council to know when making a selection for members? | am able to make decisions based on facts and the information provided, without allowing emotions or personal opinions to sway the decisions. Please attach a resume with related previous experience (if available). Please initial the questions below with your acknowledgement and understanding. Vip If you miss three consecutive meetings, or three meetings within a six-month period, you may be removed from office. ip All members must maintain Wickenburg residency in order to remain in office. Vo Committing a felony or certain crimes will automatically remove you from office. lip Ifyou are no longer able or willing to serve, please contact your board chair and staff liaison. 09-03-2025 f SIGNATURE 0 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 P/ KRI25 Applicant Notified Date r 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 Boe ontieeal Gey TO SERVE ON A COMMISSION, COMMITTEE OR BOARD wen wickenbuigarnev POSITION APPLYING FOR (Ail 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) O Community Programming Advisory Committee (Meets every other month on a Wednesday at 4:00 PM} OC Economic Development and Transportation Advisory Committee (Meets every other month on a Wednesday at 4:00 PM) O 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) W Public Safety Retirement Boards (Meets 2 times per year) Name: __M\ 10d LeTou “Daave Last First Residence Address: ; In Town of Wickenburg town limits Mailing Address: Po Street Wikerrdu ps Aerrowa &s258 City State Zip Code How long have you lived in the Town of Wickenburg? LAY Yeas Are you a registered voter in Wickenburg? %-*ES oO 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: Have Serves OF TA Committe oe MAN Yones Paes CAadan 2) What motivated you to apply for this specific committee? Love Re Ava ipTadt 12 Rasr Respordces 3) What do you see as the vision for the committee? COUeRSIGHT 4) What brought you to Wickenburg? What other organizations in Wickenburg do you volunteer at? Pastor. A cituecn Ciow8 ar, r HeePrrac - Chala Davee bepactinesr cilap law 5) Is there any additional information that you think would be heipful for the Council to know when making a selection for members? Please attach a resume with related previous experience (if available). se 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. = All members must maintain Wickenburg residency in order to remain in office. Xu Committing a felony or certain crimes will automatically remove you from office. a ve If you are no longer able or willing to serve, please contact your board chair and staff liaison. 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 _| 5/9 /25- 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.