Board Member Application

Please read the job description and then sign your application. Please make sure we have a digital photo of you to put on the election information flyer.
Name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
Address
Address: Line 2
City
State and Zip Code
Reference name

First NameLast Name
1st Reference name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
2nd Reference name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
3rd Reference name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
Please share your employment experience.
Please describe your volunteer/Board experience.
Why do you want to serve on the Silverton Senior Center's Board of Directors? This statement will be printed on the ballot (Limit of 50 words).
I have read the Board job description and agree, if elected, to uphold the responsibilities outlined. By submitting your name, you agree to this statement.

First NameLast Name
You can upload a photo of you here:

Cancelof
Thank you for your interest!
Should be Empty: