MCM Board of Directors

1

Name

First Name

Last Name

2

Phone Number

Please enter a valid phone number.

3

Email

example@example.com

4

Please explain your interest in joining our Board of Directors in alignment with MCM's mission:

5

Please list any relevant organizational or community affiliations that you believe may be applicable to your participation on the Board.

7

Other skill(s) of yours that you would like to utilize?

8

What would you like to get for yourself out of your participation on the Board, e.g., what types of experiences, skills to develop, interests to cultivate for you, etc.?

9

Signature

10

Date