Join S.W.A.T. TEAM

Your Name*

First NameLast Name

Date*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Area CodePhone Number

Your E-mail Address*

Are You Currently apart of any other organization focusing on Domestic Violence?*

YesNo

Which Location would you like to join?

Title/Profession*

Company/Organization *

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Work Phone Number

Area CodePhone Number

Extension

Please List your current and past board experiences*

Please list your skills and expertise *

Please list your skills and expertise*

What is your educational background?*

Please describe in detail you strength and weakness?*

What do you feel is essential to ensure the board and staff are successful in attaining the goals for Survivors With A Testimony (S.W.A.T.)*

What connection, expertise, or resources do you bring to S.W.A.T. *

Please detail your interest in joining S.W.A.T.*

What type of Board Task do you prefer?*

The board will have 4 initial committees 1)Board Building & Governance 2) Finance 3) Development and 4) Program which one will you like to be a part of.*

Any special talents or skills you have that you feel would benefit our organization?*

AdministrationFundraising & EventsSupport ProgramsS.W.A.T. Representative, Advocate, or Speaker

If applying for fundraising and events please indicate your expertise in this area. *

How much time will you dedicate to S.W.A.T. a month. *

3 hours a week, 2 hours a day, 12 hours a month etc.

S.W.A.T. board is exciting and very engaged working together. NC and Indiana Board meets every third Thursday and have a total of 12 meetings per year members are required to be in attendance to 9 meetings to stay active. Board members are required to be timely and present to every meeting. We are asking each member to commit to atleast 3 hours per month inside or outside meeting time. Board members are encouraged to participate in fundraising and development activities. Board Members are asked to commit to their roles for atleast one year are you able to make this commitment.*

YesNoMaybe

S.W.A.T. BOARD monthly donation of $15 is due by the 15th of each month. Our Gala ticket replaces our monthly donation in October. Starting January 2023 there is a annual membership fee of $75 due by January 31st of each year in addittion to monthly fees. Are You (financially) able to commit to this board financially?*

YesNo

Any concerns to the above statement type here.*

After your application has been renewed you will receive a email from survivorswithatestimony@gmail.com requesting a time and date for our secretary to interview you and see if you are a great fit for the board. Thank you for your interest.

I, certify by my signature that the information obtained in this application and on my resume is accurate and true to the best of my knowledge. As a volunteer of our organization I agree to abide by the policies and procedures. I understand that I will be volunteering at my own risk and that the organization, its employees and affiliates, cannot assume any responsibility for any liability for any accident, injury or health problem which may arise from any volunteer work I perform for the organization. I agree that all the work I do is on a volunteer basis and I am not eligible to receive any monetary payment or reward. An electronic signature is accepted. Please Sign Below:

Survivors with a Testimony (S.W.A.T. do not discriminate on any basis race, sex, age or religion.

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