Peoria Proud Board of Directors Candidate Application
Disclosure Statement: This statement is to inform any interested applicants that the answers you provide within this application will be utilized only for the Board of Directors’ review of all applications. Any answers can be left incomplete at the applicant’s personal discretion, and omitted information will not affect the review of the application or decision process in candidate selection.
Name *
First Name MI Last Name
Your answer
Preferred Pronouns *
Your answer
Residence
Address
Your answer
Phone *
Your answer
Email  *
Your answer
Spouse’s Name (if applicable) *
Your answer
Employer
Name
Your answer
Address
Your answer
Phone
Your answer
Email 
Your answer
Type of business or organization
Your answer
Primary service(s) and area/population served
Your answer
About You
Preferred Method of Contact *
Preferred Mailing Address
Please list boards and committees that you serve on, or have served on. *
(business,civic, community, fraternal, political, professional, recreational, religious, social) Include Organization, Role/Title & Dates of Service
Your answer
Education/Training/Certificates *
Your answer
Have you received any awards or honors that you’d like to mention? *
Your answer
How do you feel Peoria Proud would benefit from your involvement on the Board? *
Your answer
Skills, experience and interests *
(Please click all that apply)
Required
Limitations (any conflicts you have due to employment or other obligation) *
Your answer
Please let us know anything else you would like to share.
Your answer
Thank you for applying!
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