Illinois Voices Board Application

Contact Information...
Name*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Is this phone a:*

Cell PhoneHome PhoneWork Phone
Can you receive text messages on this phone?*

Yes, and I have unlimited textingYes, but I have limited texting or pay for each textNo
Tell us about yourself...
Are you employed?*

Yes, full timeYes, part timeNo, but lookingNo, not looking
Are you (select most appropriate):*

On a public registryA relativeA friendOther
Are you on parole or probation?*

Yes, paroleYes, probationNo
What is the highest level of education you have completed?*

Less than High SchoolHigh SchoolSome CollegeAssociate's DegreeBachelor's DegreeMater's Degree or Higher
Tell us about your skills and availability...
Do you have a computer?*

YesNo
Do you have a car?*

YesNo
Are you available to travel?*

Yes, whenever neededYes, occasionallyNo
How many hours per week/month are you able to dedicate to Illinois Voices?
Number of hours:*
Per:*

WeekMonth
Are you able/willing to attend monthly board meetings (via videoconferencing)?*

YesNo
Do you have legal training or a background in law?*

YesNo
Is yes, please explain:
Tell us why you would like to join the Illinois Voices Board*
List any other non-profit organizations you have worked with and in what capacity.*
Should the registry be abolished, fixed, made Law Enforcement Only (LEO), or some combination? Explain why you feel that way.*
By hitting the "Submit" button, you agree to the following:

I have read and agree with the general mission of Illinois Voices as stated on their website. I do not support, nor am I a member of, any organization that advocates or condones sexual activity between adults and children or any organization that promotes or condones illegal activity of any sort. I believe that the best way to stop sexual abuse of any kind is through effective legislation based on empirical research. Although I may not agree with all the laws that have been passed regarding public conviction registries, I agree to follow those laws until such time as they are changed. I understand that my service to Illinois Voices is completely voluntary and may be stopped at any time by either myself or Illinois Voices. I understand that I am a volunteer for Illinois Voices and agree not to present myself as an official representative of Illinois Voices, nor to speak on behalf of Illinois Voices, except when directly authorized by the Board of Directors of Illinois Voices for Reform, Inc.
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