Personnel Action Review Board Application
The Personnel Action Review Board (PARB) was established to review employee appeals of disciplinary actions resulting in termination, reduction in pay, demotion or suspension without pay and review employee layoff actions as requested.
If you are interested in serving on the PARB, please complete this application. To be eligible, your physical address must be within the corporate limits of Marana, and you may not serve as a member of any other board or commission of the town.
The Town will use this information when considering appointments to the PARB. Please note that the Town’s policy is to not share personal contact information when requested by private or public entities. However, this application is a public document and may be subject to public disclosure if requested under the Arizona Public Records Law. In the past, the Town has received requests for lists of active committee members, including requests from media sources and political officials.
First Name*
Last Name*
E-mail Address
Mailing Address*
City*
State
ZIP*
How many years have you lived at this address?*
How many years have you lived in Marana?*
Phone - Day
Phone - Home*
Occupation
Employer
I am currently, or have previously served on a board, committee, or commission of another public or private organization.*
Committee
Dates
Describe your qualifications for serving on the PARB:
Why are you interested in serving on the PARB?
Describe any other personal involvement in local community activities (e.g., civic club, service or fraternal organization, professional association, volunteer, etc.)
What is your normal availability / preference for attending meetings?
Available (check all that apply)
Day of Week
Time of Day
Hours per month*
Are you able to serve a full 3 year term?*
References: List two people who know about your qualifications and interest.
Name
Address
Relationship
Day Phone
Name
Address
Relationship
Day Phone
IMPORTANT LEGAL INFORMATION AND REQUIREMENTS FOR PARB MEMBERS
Anyone appointed to a committee, board or commission by the Town of Marana is a “Public Official” per Arizona law and a “PARB member” per the Town’s Personnel Policies and is obligated to adhere to related standards of conduct and ethics. In particular, the Town of Marana needs to be aware of any actual or potential conflict of interest that could occur if you are appointed to the PARB.
List any financial or ownership interest that you have or a relative has that will create a conflict of interest for you. This includes anything that you or a relative own or have a substantial financial stake in. There are several kinds of remote interests that do not create a conflict of interest and do not need to be included. For example, it is not a conflict of interest to participate in a decision about a corporation you or a relative own stock in, as long as you and/or your relatives own less than 3% of the shares of the corporation and get less than 5% of your and/or your relative’s total annual income from it. It is also generally not a conflict of interest to participate in decisions about nonprofit corporations you volunteer for, a government entity you or a relative work for, your tenant or landlord, or a class of people that includes you. A relative includes your spouse, child, grandchild, parent, grandparent, sibling, their spouses, and your spouse’s parent, sibling or child. If you have any questions about whether you or a relative have a financial or ownership interest that should be listed, please contact the Town Clerk or the Town Attorney.
Name of Business
Person with Interest
Type of Interest
Name of Business
Person with Interest
Type of Interest
Have any of the above businesses conducted any business (e.g., supplier of goods or services, contractor, consultant) with the Town of Marana in the past 24 months?
If Yes, Explain
Are you, a relative, or any member of your household an employee of the Town of Marana?
If Yes, Explain
List by name any compensated lobbyist with whom you, or a relative, or a member of your household shares any direct economic interest such as a partnership, joint venture or similar business relationship.
I affirm that all of the information contained in this application is true to the best of my knowledge, and that I understand that any misstatement of fact or misrepresentation of credentials may result in this application being disqualified from further consideration. I also agree to abide by the Town’s Code of Conduct and notify the Marana Human Resources Director of any changes to this information.
Electronic Signature*
Date
* indicates required fields.
