Prospective Advisory Council Member Application
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Email *
Candidate Name: *
Mailing Address: *
City, State & Zip Code: *
Phone Number:
Current Employer: *
Current Position: *
Work Phone: *
Please select areas of expertise/contribution you feel you can make to further the mission of LifeSmart Education. *
Required
Please list boards and committees that you serve on, or have served on (business, civic, community, fraternal, professional, recreational and social). Please include the organization's name, role/title and dates of service. *
Why are you interested in serving as an Advisory Board member for LifeSmart Education? *
How do you feel LifeSmart Education would benefit from your involvement on the board? *
Please share any other information you feel is important for consideration of your application to serve as a LifeSmart Education Advisory Council member. *
Are you willing and able to attend Advisory Council Meetings? *
Required
Are you willing to uphold the responsibilities assigned to you? *
Required
Are you willing to donate or provide sources for donations to the organization? *
Required
By signing below, I attest that the information I have provided is true and correct. Additionally, my signature represents my attestation that I am comfortable performing the duties indicated: *
Date: *
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