2. Application for all Tolleson Board and Commissions

4. Commission members appointed by the City Council must be eighteen years of age or older and reside within the City of Tolleson.
   
   Please keep in mind, that due to the postal service, many residents in Phoenix may have a Tolleson mailing address; so they do not reside in Tolleson. The City that provides your utility services is the City you reside in. View the Tolleson Boundry Map at https://www.tolleson.az.gov/DocumentCenter/View/6733.

6. Board and Commission Descriptions
   • Planning and Zoning Commission - Serves to analyze, review and make recommendations to the Council regarding land use and development-related issues.
   • Public Safety Personnel Retirement System Board - Serves as an advisory body to the members for the purpose of administering and making the provisions of the retirement system for police and fire.
8. First Name*
9. Last Name*
11. Address*
12. State*
13. Zip Code*
15. Home Phone
16. Mobile Phone
17. Email Address*
19. Employer/Occupation*
21. Business/Company Name
23. Business Address
24. Business State
25. Business Zipcode
27. 1. I am interested in serving on the following Board or Commission:*

    1. Planning and Zoning Commission
    2. Public Safety Personnel Retirement System Board
29. 2. Are you currently a member of a Tolleson Board or Commission?*

    1. Yes
    2. No
31. 3. Are you a resident of the City of Tolleson?*

    (Please refer to the attached Tolleson Boundary Map)

    1. Yes
    2. No
33. 4. Professional experience highlights*
34. Attach resume if available
36. 5. What experience do you think qualifies you to be a Board or Commission Member? Include information about other organizations, boards and committees that you have served as well as any specific training/workshops such as Citizen’s Academy, etc.*
38. 6. Why are you interested in serving on a City Board or Commission?*
40. 7. If appointed, how much time would you be able to devote for meetings or projects and events?
42. Hours per week?*
43. Hours per month?*
45. 8. Would you be available:
47. During the day?*

    1. Yes
    2. No
48. In the evening?*

    1. Yes
    2. No
50. 9. Community activities that you are involved in:
52. Acknowlegement*

    1. I agree

    By selecting this box, I understand that this application is considered a public record. The City Council appoints all members and any alternates.

    Under penalties of perjury, I declare that to the best of my knowledge and belief the information stated above is true, correct, and complete, and selecting this check box is also equal to my signature.

Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field