Smyrna Charity Assistance Committee Application

Committee Application: Smyrna Charity Assistance
Town of Smyrna Committee Application
Smyrna Charity AssistanceThe Smyrna Charity Assistance Fund provides financial aid to selected nonprofit charitable organizations that provide year-round services benefiting the general welfare of the residents of the municipality, and meet the criteria established and set forth by the Town Council. The Board will be composed of six members, one of which shall be the Mayor or the appointed Mayor’s appointed Town Council designee. The remaining members will be appointed by Town Council by majority vote.

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The Charity Assistance Fund Board is scheduled to meet on the second Thursday of each month at 5:00pm at City Hall (315 South Lowry Street).

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Date*

Committee(s) Requested* Arts Commission Charity Assistance Fund Planning Commission Athletic Committee Historic Zoning Commission Project Assistance Beer Board Industrial Development Board Sister City Committee Board of Adjustment & Appeals Packaged Liquor Board Smyrna Housing Authority Board of Zoning Appeals Parks Advisory Board Storm Water Advisory Rutherford County Library System

Full Name*

Street Address*?

City*

State*

Zip Code*

How long have you lived in Smyrna*

Are you a registered voter?*

Yes

No

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 AddressN/A

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?*