Metro Nashville | Boards and Commissions: Board Application

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Profile

Which boards would you like to apply for? You may select up to 3 *

Please select a Board

First Name *
Middle Initial
Last Name *
Suffix

Phonetic Spelling of First and Last Name

Email Address *

Home Address *
Suite or Apt
City *
State *
Postal Code *

Primary Phone * Primary Phone
Alternate Phone Alternate Phone

How long have you been a resident of Davidson County *

What Council District do you live in? *

Click here to use the ArcGIS Web Application to find your Council District.

You are required to provide the address of your residence in Davidson County but may not wish to publish that information online. Please use the fields below if you would like to have alternative contact information used for publishing on Nashville.gov.

Web Street Address

Web City

Web State

Web Zip Code

Web Phone Number

Web Email Address

Employer
Job Title

Describe any potential conflict of interest your appointment may present. *

Are you a registered voter? * Yes No

Are you an Elected Official? * Yes No

Are you a lobbyist? * Yes No

Interests & Experiences

Upload a Resume
Accepted file types: RTF, DOC, DOCX, PDF, TXT, JPG, JPEG, GIF, PNG

Please upload a headshot photo.
accepted formats: doc, docx, rtf, txt, and pdf

Please provide 3 recommendations. (Name, Email, and Phone Number) *

Describe your qualifications and/or reasons why you wish to be confirmed for this appointment *

Have you previously served on a board or commission? * Yes No

If you answered yes, how many years of service have you served on a Metro Board or Commission

Demographics

Some boards and commissions require membership to be racially, politically or geographically proportionate to the general public. The following information helps track our recruitment and diversity efforts.

Date of Birth *

Race *

Ethnicity *

Gender *

Do you wish to openly identify as LGBTQ? *

Sexual Orientation

Do you wish to identify the existence, but not the nature, of a disability? Yes No

Highest Level of Education Completed *

Income Level

Acknowledgements

Will you agree to attend Metro Government's cultural diversity/sexual harassment training, within three (3) months of this appointment? *

I agree that I will attend Metro Government's cultural diversity/sexual harassment training, within three (3) months of this appointment

I Agree *

CURRENT BOARDS & COMMISSION MEMBERS do not need to complete the Acknowledgement of Ethical Issues form again as this is currently already on file.

Have you read, signed and returned your Acknowledgement of Ethical Rules form? Yes No

If no, please download, sign and then upload (below) the Acknowledgement of Ethical Rules

Upload Acknowledgement of Ethical Conduct Agreement Upload
accepted formats: doc, docx, rtf, txt, and pdf

Boards and Commissions

Consistent with Title II of the ADA, the Metropolitan Government (“Metro Nashville”) will not discriminate against any individual on the basis of disability in the full and equal enjoyment of the services it provides by excluding or providing unequal treatment to persons with disabilities. 42 U.S.C. § 12132; 28 C.F.R. § 35.130. Metro Nashville shall make reasonable modifications and/or accommodations where necessary to avoid discrimination on the basis of disability. 28 C.F.R. § 35.130(b)(7)(i). Specifically, where an individual’s disability prevents that person from attending meetings of a local government board, commission, or other body, in person, Metro Nashville will permit such individuals to fully participate virtually. Metro Nashville board and commission members’ participation in such virtual meetings shall not be diminished in any way, and they shall be entitled to vote, count towards a quorum, make and second motions, and otherwise permitted to participate in the same manner in which they would have if they were attending the meeting in person.

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Metropolitan Government of Nashville and Davidson County

Boards and Commissions Application Form

Profile

Interests & Experiences

Demographics

Acknowledgements

CURRENT BOARDS & COMMISSION MEMBERS do not need to complete the Acknowledgement of Ethical Issues form again as this is currently already on file.

Boards and Commissions

Profile

Interests & Experiences

Demographics

Acknowledgements

***CURRENT BOARDS & COMMISSION MEMBERS do not need to complete the Acknowledgement of Ethical Issues form again as this is currently already on file.***

Boards and Commissions

CURRENT BOARDS & COMMISSION MEMBERS do not need to complete the Acknowledgement of Ethical Issues form again as this is currently already on file.