Heart of Gold Shelter Board Member Interest Form

BOARD MEMBER INTEREST FORM

Thank you for your interest in serving on the Heart of Gold Shelter Board of Directors! Completing this form is the first step in helping us get to know you and in sharing more about this meaningful leadership opportunity. Once we receive your submission, we’ll send you the next step: completing our Board Candidate Application.
Date*

MonthDayYear
Name*

First NameLast Name
Email*
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Preference*

DayEvening
Printed Signature*
Signature*

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Date*

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Date
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