Board of Directors Candidate Application
Personal
Your Name
*
Address
*
Phone
*
Format: (000) 000-0000.
Email
*
example@example.com
Employer
Name
*
Your Title
*
Address
*
Phone
*
Format: (000) 000-0000.
Email
*
example@example.com
Type of business or organization
*
Primary services and area/population served
*
Preferred Method of Contact:
*
Personal
Work
Please list board and committees that you serve/d on
e.g. business, civic, community, fraternal, political, professional, recreational, religious, social
1. Organization
Role/Title
Dates of Service
2. Organization
Role/Title
Dates of Service
3. Organization
Role/Title
Dates of Service
Education/Training Certificates
Have you received any awards or honors that you'd like to mention?
How do you feel NAMI Northern Lakes would benefit from your involvement on the Board
*
Skills, Experience & Interests (Check all that apply)
*
Please list any groups organizations or businesses that you could serve as a liaison to on behalf of NAMI Northern Lakes
Please tell us anything else you'd like to share
Submit
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