Interested in joining our board?Please fill out the application below and our Executive Director will contact you. Name * First Name Last Name Email * Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Cell Phone * (###) ### #### Company Name (if applicable) Work Address Address 1 Address 2 City State/Province Zip/Postal Code Country Work Phone (###) ### #### Are you over 21 years old? * Yes No Please indicate the experience and talents you bring to the Board of Directors. * Check all that apply. Professional Relationships Law Enforcement/Corrections Management Fundraising Medical/Mental Health Budget/Finance Public Relations Marketing/Events Government Planning Investments Legal Affairs Other Are you willing to commit to attending monthly board meetings? * Yes No Each board member is required to make a personal or corporate gift to organization. As a board member, are you willing to give personally or through your company to the organization? * Yes No Are you willing to commit to sub committees as needed? * Yes No Are you willing to participate in fund development activities? * Yes No Are you willing to submit to a background check? * Yes No Do you serve on other non-profit boards? If yes, please explain. Please include the name of the organization and the date of your term expiration. Do you serve on any for-profit boards? If yes, please explain. Please include the name of the company and the date of your term expiration. Currently, do you anticipate being willing/able to serve two terms on the board of directors? Each term is three years. Yes No Additional information you would like to share with us: Thank you for your application. Our Executive Director will contact you soon.
