Boards and Commissions Application

The preferred method of applying for a Board or Commission is by completing the on-line application below. However, a paper application be printed out, completed and sent by US Mail or scanned and e-mailed.

Application:

A current application and resume are required both for initial appointment or reappointment consideration.

Resume Required:

You may submit your resume in PDF format using the form below.  

Instructions for Letters of Recommendations:

The Governor’s Office welcomes and needs written assessments of the applicants' skills, expertise, ethics and any other characteristic relevant to an individual's potential for an appointment. Many applicants solicit letters of reference supporting their efforts at an appointment. However, applicants are advised "more" is not necessarily "better." The Governor’s Office would prefer to receive no more than 10 substantive e-mails regarding each applicant. The preferred means of communicating recommendations to the Governor’s Office is through e-mail. Please direct any such e-mails to bc@az.gov.

Contact Information
Board/Commission Interest

Please select a board/commission of interest.

Employment Information
Personal Information
Background Investigation

Note: Either a Driver's License or State ID is required to complete a background investigation.

Note: a Driver's License or State ID is required to complete a background investigation.

A SIGNED BACKGROUND INVESTIGATION AUTHORIZATION FORM IS REQUIRED TO COMPLETE YOUR APPLICATION

Complete and sign the Background Investigation Authorization form and return by post, email or fax to:

Laddie Shane, Director
Boards and Commissions
1700 W. Washington Street, Suite 250
Phoenix, AZ 85007
Email: bc@az.gov
Fax: 602 542-1381
Professional Experience
Please include education including any degrees completed.
List THREE references. Include the NAME and PHONE of the Business/Company/Agency.
Attach your resume in PDF format.
Files must be less than 2 MB.
Allowed file types: pdf.
Affirmation of Eligibility
In accordance with A.R.S. 38-201, every state officer shall not be less than eighteen years of age, a citizen of the United States and a resident of this state.
Are you currently charged with or have you ever been arrested for or convicted of any felony, misdemeanor, or violation of the Uniform Code of Military Code of Justice?
To your knowledge, has any formal charge of professional misconduct ever been filed against you by a licensing or regulatory board or by any other disciplinary body in any jurisdiction?
In the past five years, have you ever been reprimanded, demoted, disciplined, placed on probation, suspended, cautioned or terminated by an employer as a result of your alleged consumption or use of alcohol, prescription drugs or illegal drugs?
Please state the circumstances under which such action was taken and the background and resolution of such action
Is there any possible conflict of interest, whether financial or personal, or other matter that would create problems or prevent you from fairly and impartially discharging your duties as an appointee?
Is there any information that, if it came to light, would embarrass you or reflect negatively on your appointment?
Authenticity of Information

I certify that the facts contained in this application are true and correct to the best of my knowledge. I have reviewed the statutory requirements governing the board/commissions in which I have expressed an interest and confirm that I meet those requirements. I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my qualifications and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damages that may result from furnishing the same to you. Entering my name and the date below has the same legal ramifications as a hand signed document.

To sign, type your name
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Boards and Commissions Profiles

Research the Board or Commission you are interested in serving on; find out how it was established, how it is funded and staffed, its duties and responsibilities, current members and their terms, and more... View Boards and Commissions list

Contact Us

Laddie Shane, Director
Boards and Commissions

1700 W. Washington Street, Suite 250
Phoenix, AZ 85007