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Boards and Commissions Application
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BOARD/COMMISSION INTERESTED IN:
Select a Board/Commission
Adult Oriented Establishment Board
Agricultural Extension Committee
Air Pollution Control Board
Board of Adjustment
Building Code Board
Downtown Memphis Commission
Center City Development Corp.
Downtown Parking Authority
Center City Revenue Finance Corp.
Community Advisory Board (CSA)
Cross Connection Board
Electrical Code Board
Emergency Communications (911 Board)
Film & Television Commission
Groundwater Control Board
Health, Education & Housing Facility Board
Head Start Policy Council
Industrial Development Board
IT Steering Committee
Joint Board of Appeals
Land Use Control Board
Mechanical/Gas Code Board
Municipal Solid Waste Regional Board
Plumbing Code Board
Public Building Authority (FedEx Forum)
Public Records Commission
Sports Authority Corporation
Prevailing Wage Commission
Community Redevelopment Agency
Juvenile Justice Consortium
Date of Birth
City, State, Zip
Name of Spouse
Select a State
How many years have you been a resident of Shelby County?
Have you ever been convicted of a felony?
Do you give Shelby County Government authorization to request that the Shelby County Sheriff's Department perform a background check?
Do you also understand that other sources including the official state websites listing sexual predators and a check of outstanding balances owed to departments and offices of county government may be performed?
List any affiliation or ownership interest you have in any business, corporation or partnership and if such business contracts with or sells products or services to Shelby County Government.
List members of family, where employed, and whether or not their employer contracts with or sells products or services to Shelby County Government.
Pursuant to Resolution #26 adopted July 26, 1993, as amended, each person who submits his or her name for nomination to serve on a board, authority, or commission subject to approval by the Shelby County Board of Commissioners shall submit a list of all private, county, social, athletic or professional clubs of which that person is a member. In the event it is determined that any such clubs are discriminatory in choosing their members on the basis of race, sex, or religion, the Shelby County Board of Commissioners may use this information in voting to reject the nominee.
Pursuant to the aforementioned Resolution you are hereby required to list all private country, social, athletic or professional clubs of which you belong.
List below any of the aforementioned clubs of which you belong that do not have female members.
List below any of the aforementioned clubs of which you belong that do not have minority group members (e.g. African American, Hispanic, Asian).
Do any of the aforementioned clubs of which you belong discriminate in selecting members based on race, sex, or religion?
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