Newry and Mourne Community Transport Board of Directors Application Form

Board of Directors Applicant Form
Personal Information
Name

Last NameFirst Name
Date

MonthDayYear
Date
Email
example@example.com
Address

Street Address

Street Address Line 2

CityCounty

Postal / Zip Code
Mobile Number
Home Phone
Birth Date*

MonthDayYear
Gender Identity

MaleFemaleOther
Business/Work Information
Title/Profession
Company Organization
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Work Phone
Please list your current and past Board experiences
What are your current associations and/or club affiliations? (include titles if possible)
Please list your skills and expertise
What experiences, expertise, connections, or resources would you bring to NMCT?
Please detail your interest in joining this Board
Have you ever been engaged in any specific fundraising efforts? If so please detail below
Board members are required to commit to attending monthly or bi monthly meetings. These meetings are held both virtually and face to face at a time agreed by all. Is this something you agree to

YesNoMaybe
Thank you for your interest.

I certify, by my signature, that the information contained within this application and all supporting documents (i.e., resume, recommendation letters, etc.) is true, accurate, and complete to the best of my knowledge. An electronic signature is accepted.
Signature

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Date

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Date
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Board of Directors Applicant Form