2. 
3. 
5. VOLUNTEER BOARDS & COMMITTEES APPLICATION FORM
7. First Name
8. Last Name
10. Spouse's Name
12. Address1
14. Address2
16. City
17. State
18. Zip
20. Home Phone
21. Business Phone
22. Email
24. Employer
25. Occupation
27. Spouse's Employer
28. Occupation
32. 1. How many years have you lived in the City of Spring Hill?*
34. 2. Community involvement and activities:*
36. 3. Which Board, Commission, or Committee are you applying to serve on? Please check all that apply.*

    1. Board of Zoning Appeals
    2. Historic Commission
    3. Library Board of Trustees

    1. Parks & Recreation Commission
    2. Planning Commission

    1. Transportation Advisory Committee
    2. Town Center Task Force
38. 4. Please summarize, briefly, why you would like to serve on this Board/Committee:*
40. Following are questions which request additional information that may be pertinent in considering appointment to City Boards, Commissions, or Committees. Your responses will not necessarily provide grounds for disqualification, but rather, provide an opportunity for you to identify potential conflicts or relationships that should be disclosed prior to an appointment being made.
42. 5. Previous governmental bodies/elective offices you have served on. Please include the dates you served.*
44. 6. Please list any civic or charitable organizations to which you have belonged. Include Title/Office held and dates you served.*
46. 7. What special interests/skills/talents would you bring to the Board or Committee?*
48. 8. Please provide three personal references.
50. 1.*
52. 2.*
54. 3. *
56. 9. What would you like to see accomplished during your time on the Board/Committee?
58. 10. If appointed to the Board/Committee you are applying for, are you aware of any potential conflicts of interest in regard to you and busininess before the Board? If so, please describe.
60. By submitting this application, I confirm that the above information is true and correct; that I am over the age of 18; and if I am appointed to a Board or Committee, I affirm that I will regularly attend its meetings and functions.
62. Signature*
63. Date*
    Date
65. 

66. This application is being submitted to April Goad, City Recorder. 
    agoad@springhilltn.org

    OFFICE OF THE CITY RECORDER

    199 Town Center Parkway • PO Box 489
    Spring Hill, Tennessee, 37174

    931-486-2252, ext 206

Leave This Blank:


68. 1. Receive an email copy of this form.
69. Email address

    This field is not part of the form submission.

70. Submit Submit and Print

* indicates a required field