[Pinal County] San Tan Valley Town Council Application

San Tan Valley Town Council Application

Phone Number

Are you at least 18 years of age?

Yes

Are you a current registered active voter?

Yes

Are you able to read and write the English language?

Yes

List your current occupation:

Are you now, or have you ever served on a municipal/governmental board, commission, or committee?

Yes

Please provide name of board, commission and/or committee and dates served:

Are you a legal Arizona resident living within the Town of San Tan Valley incorporation boundaries?

Yes

Your length of residency (Years/Months) within the Town of San Tan Valley incorporation boundaries?

Please describe how your experience (career/civic activities/volunteering, etc) makes you best qualified to serve on the inaugural council for the Town of San Tan Valley?

Why would you like to be appointed to serve the citizens of San Tan Valley?

In your opinion, what are the highest and most immediate priorities for the inaugural council for the Town of San Tan Valley?

Please attach your letter of interest, resume, and any other documents outlining your qualifications for office:

Click Here to Upload

AUTHORIZATION:
I, hereby authorize Pinal County to and/or its agents to investigate my background, references, character, past employment, consumer reports, education, and criminal history record information, which may be in any state or local files, including those maintained by both public and private organizations, and all public records, for the purpose of confirming the information contained on my application and/or obtaining other information which may be material to my qualifications for employment or appointment. I hereby consent to Pinal County’s verification of all the information I have provided on my application form. I also agree to execute as a condition of employment or appointment or a condition of continued employment or appointment, any additional written authorization necessary for Pinal County to obtain access to and copies of records pertaining to this information.

APPLICANT RELEASE:
With regard to the foregoing disclosures, I hereby agree to release any person, or private or public entity from any and all causes of action that otherwise might arise from providing Pinal County with information it may request pursuant to this release and authorization form. I understand that any false information or statements, or misrepresentation by omission, made by me on the application or any related documents will be sufficient for rejection of my application or for my immediate discharge should occur if such falsification or misrepresentation is discovered after I am employed.

Sign Here

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.