Board Application Form

Today's Date*

MonthDayYear
Date
Are you currently a member of Angels Surviving Cancer?*
Candidate Name:*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Mailing Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Relevant Experience and/or Employment. Please attach resume.
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Are you currently employed?*

YesNo
If yes, current position/employer:
Please select area(s) of expertise and/or contributions you feel you can make to further the mission of Angels Surviving Cancer, Inc.:*

FundraisingSpecial EventsMediaPolicy DevelopmentStrategic PlanningMarketingPublic Policy AdvocacyEvaluationITTechnology
Please list any prior experience serving as a Board member for any other non-profit organizations:*
What other volunteer commitments do you currently have?*
Please tell us why you are interested in serving as a Board member for Angels Surviving Cancer, Inc.?*
Please share any additional information you feel may be important for consideration of your application to serve as an Angels Surviving Cancer, Inc Board member.*
Thank you for taking the time to apply for a Board of Directors position with Angels Surviving Cancer, Inc. We appreciate your interest in our Non-profit organization. We will contact you directly once your application is submitted and reviewed.

Please contact us directly if you have any questions or concerns at info@angelssurvivngcancer.org

Thank you again for your interest.
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