Committee Application

Date*

Committee Requested*

Full Name*

Street Address*

City*

State*

Zip Code*

How long have you lived in Smyrna*

Are you a registered voter?*

Yes

You will need to provide verification of your address by submitting a copy of your driver's license or other State-issued ID

If you are unable to upload a file, here are other ways to submit a copy of your driver's license or State-issued ID: ✉️ Submit via e-mail: boardapplications@townofsmyrna.org, 📠 FAX to (615) 355-5715 or 🗎 Deliver in person to City Hall (315 South Lowry Street, Smyrna)

Contact Information

Phone Number*

Alternate Phone Number

E-mail Address*

Employment

Current Workplace

Job Title

Length of Employment

Business Address

Business Phone Number (Include Extension)

Education

Other Information

Past / Current Community Involvement*

Professional Organizations

Explain why you would like to serve on this committee*

Do you know of any potential conflicts?*

Services

Forms

SMYRNA

Committee Application

Contact Information

Employment

Other Information