Board of Directors Application
Name
*
First Name
Middle Name
Last Name
Preferred Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
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Employer
Employer Name
Your Title
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Does your employer offer paid community Service?
Yes
No
Would your employer consider becoming a funding partner for Soteria CDC?
Yes
No
Maybe
If yes, Name & Phone Number of contact person
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What is your preferred method of contact?
Work
Residence
Please list boards and committees that you serve on or have served on (business, civic, community, fraternal, political, professional, recreational, religious, social).
Optional - Have you received any awards or honors that you'd like to mention?
How do you feel Soteria CDC would benefit from your involvement on the Board?
Skills, Experience & Interests (Select all that apply)
Finance, Accounting
Personnel, human resources
Nonprofit experience
Community service
Policy development
Program eveluation
Public relations, comunications
Education, instruction
Special events
Grant writing
Fundraising
Outreach, advocacy
Other
If "Other", please explain:
Please list any groups, organizations or businesses that you could serve as a liaison to on behalf of Soteria CDC?
Please tell us anything else you'd like to share.
Thank you for applying.
Submit
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