Logan Strong Foundation Board Application

Logan Strong Foundation

Board Member Application
Personal Information
Name

First NameLast Name
Address
Email
example@example.com
Cell Phone
Format: (000) 000-0000.
Home Phone
Format: (000) 000-0000.
Employment Information
Present Employer
Current Position
Hire Date

MonthDayYear
Date
Employer Address
Employer Contact
Work Phone
Please enter a valid phone number.Format: (000) 000-0000.
Type of business or organization
Education
Institution
Degree and Major
Institution
Degree and Major
Institution
Degree and Major
Please list your past and present memberships on boards, committees and organizations: (business, civic, community, fraternal, political, professional, recreational, religious and social)
Organization
RoleTitle
Dates of Service

MonthDayYear
Date
Reason for Leaving
Organization
Dates of Service

MonthDayYear
Date
RoleTitle
Reason for Leaving
Organization
RoleTitle
Dates of Service

MonthDayYear
Date
Reason for Leaving
Organization
RoleTitle
Dates of Service

MonthDayYear
Date
Reason for Leaving
Organization
RoleTitle
Dates of Service

MonthDayYear
Date
Reason for Leaving
Organization
RoleTitle
Dates of Service

MonthDayYear
Date
Reason for Leaving
Please list notable achievements in your service to the above organizations
Please describe any other volunteer experience
Please list your fundraising experience
Who recommended you for a position of the Logan Strong Foundation board? Who else do you know on the board?
Please explain why you are interested in joining the board.
Please mark the skills and/or interest you bring to our board:
Other unique talents or skill sets would you bring as a board member
References
Name
Relationship
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Best time to call
Years known
Name
Relationship
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Best time to call
Years known
Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Best time to call
Years known
Time commitment: Board meetings are held once a month approximately for two hours. Each board member is expected to serve on a committee as well. In addition, board members are asked to attend all special events and fundraisers throughout the year, including our annual retreat held the last weekend in January.
Have you ever been convicted of a misdemeanor or a felony If yes please explain
I authorize the Logan Strong Foundation to investigate my background and qualifications for purposes of evaluating whether I am qualified for the position for which I am applying. I also understand that I may withhold my permission and that in such a case, no investigation will be done, and my application will not be processed further.
Signature
Date

MonthDayYear
Date
*Please sign additional Applicant Release from Diligent Data.
Should be Empty:

Logan Strong Foundation

Personal Information

Employment Information

Education

References