Name:
Home Address:
Date:
Daytime Phone
Evening Phone
Email:
Company Name:
Business Address:
Job Title:
Contact Preference:
Work
Home
Type of Business:
Please explain your interest in participating as a member of the Advisory Board
Please explain the skills you are most proficient in and are willing to provide
As an Advisory Board Member, I would be interested in taking leadership in the following
(check all that apply).
Executive Committee
Planning Special Events
Recruiting New Members
Grant Writing
Fund Development
Organizing Educational Programs
Public Relations / Communications
Marketing
How many hours per month would you be willing to serve?
1-5 hours
6-10 hours
11-20 hours
I am able to commit time to attend quarterly Board meetings, as well as on-going committee meetings as needed.
I agree to participate in the association's fund-raising and promotional activities. It is the Board's policy that all members contribute financially and are actively involved with the association to establish a 100% participation rate to our funders
I am available to begin serving on the Advisory Board on:
