Board of Directors Application

Have you every been arrested and/or convicted of a crime?*

YesNo

If yes, please explain below.

Name*

First NameLast Name

Company*

Phone Number*

Area CodePhone Number

Email*

example@example.com

Have you, in the past or currently, serve on any other Board?*

YesNo

If yes, please explain below.

Why are you interested in becoming a Crime Stoppers Board member?*

What strengths do you feel you can contribute to SWFL Crime Stoppers?*

Can you commit to attend at least two (2) events in a 12-month period?*

YesNo

Fundraising is an important function of the Board of Directors. Will you be able to assist with fundraising efforts?*

YesNo

Are you willing to commit to one (1) morning per month (2nd Thursday of each month) to attend the Board of Directors meeting?*

YesNo

TERMS OF APPLICATION

I certify that the information contained in this application is correct to the best of my knowledge.

By submitting this application, I give SWFL Crime Stoppers representatives permission to conduct a background investigation to verify that I meet the qualifications for Board membership in the aforementioned organization.

If any information is discovered after acceptance to the program that may prove unacceptable to our mandate or that was no disclosed during the application process, it may be grounds for removal from the Board.

I have read the above and agree to provide the required information voluntarily and acknowledge that the information will be kept confidential.

Signature*

Today's Date*

Date

SOUTHWEST FLORIDA CRIME STOPPERS

Professional Reference