Request edit access
Diane Peppler Resource Center - Volunteer Board Member Application 
Please contact Katie Barkley at (906)635-0566 or director@dprcenter.org with any questions about the application or to receive a paper application. Thank you. 
Sign in to Google to save your progress. Learn more
Name (First and Last)  *
Date of Birth  *
MM
/
DD
/
YYYY
What is your gender? (Optional) 
What is your race? (Optional) 
Mailing Address (City, State, Zip) *
What are your preferred pronouns? 
Driver's License No. 
Phone Number (Cell)  *
Phone Number (Home) 
E-Mail  *
Board Meetings are conducted on the 3rd Wednesday of each month at 5:30pm. Committee meetings are held as scheduled. Zoom/online options are available. Are you able to commit to those dates?  *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Diane Peppler Resource Center.

Does this form look suspicious? Report