Scott Wilson Application

Town of Wickenburg
155 N. Tegner St. Suite A
Wickenburg, AZ 85390

CITIZEN APPLICATION FORM Phone: €28-664-5451
TO SERVE ON A COMMISSION, COMMITTEE OR BOARD www. wickenburgaz.gov

POSITION APPLYING FOR (Ail Applicants must live in the Town Ilmits):
Please only apply for one board/committee/commission, your top area of interest.
C) 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)
C 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)
© Planning & Zoning Advisory Commission (Meets monthly on the last Thursday at 5 30 PM)
Public Safety Retirement Boards (Meets 2 times per year)

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Residence Address:

Mailing Address:
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How long have you lived in the Town of Wickenburg? ete Yea 3
Are you a registered voter in Wickenburg? K YES NO

Please respond to all questions, attach a separate shee aper ifn

4) | am interested in serving and/or am qualified to serve on the Committee because:

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2) What motivated you to apply for this specific committee?
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3) What do you see as the vision for the committee?
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4) What brought you to Wickenburg? What other organizations in Wickenburg do you volunteer at?
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5) Is there any additional information that you think would be helpful for the Council to know when
making a selection for members?

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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.
All members must maintain Wickenburg residency in order to remain in office.

ye Committing a felony or certain crimes will automatically remove you from office.

apd! If you are no longer able or willing to serve, please contact your board chair and staff liaison.

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SIGNATURE ° DATE

For questions or to submit forms please send to:
Amy Brown, Town Clerk at (928) 668-0517 or

OFFICE USE ONLY — Revision March 2023
Date Application Received folgeas”
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.