Governing Board Meeting Public Comment Form

Individuals wishing to address one of the Authority's Governing Boards on specific items or during Call-to-the-Public should fill out this form completely. Upon submission, your request will be added to the public record and scheduled for inclusion at the requested Governing Board meeting.

If you have any questions, contact Administrative Director Dusty Christopherson at (623) 544-5400 or info@afma.az.gov.

First Name *

Last Name *

Organization/Company (if applicable)

Phone Number

Email Address *

Address

Select Governing Board * Arizona Fire & Medical Authority
Buckeye Valley Fire District
North County Fire & Medical District
South County Fire & Medical District

Date of Governing Board Meeting

I would like to address the Governing Board during: Agenda Item
Call to the Public

Would you like to speak in person or virtually at the Governing Board Meeting? Yes
No

If no, please leave written comments here.

* - denotes required field