Umoja Community Education Foundation Council of Elders Membership Application
Please complete all questions below.
Sign in to Google to save your progress. Learn more
First and Last Name *
Pronouns *
Cell Phone *
Street Address, City, State & Zip *
Date of Birth *
MM
/
DD
/
YYYY
Birthplace *

1. Why are you interested in serving on the Umoja Council of Elders?

2. Please describe any current or prior positions or affiliations you may have or had with the Umoja Community Education Foundation.
3. What special skills, talents or resources would you bring to the Umoja Council of Elders?
4. What special skills, talents or resources would you bring to the Umoja Council of Elders?
5. What professional or community organizations, groups or movements have you worked with?
6. Do you have any experience in conflict resolution or mediation? If so, please describe.
7. Please provide the names of two references and include their email address and telephone numbers. *
Academic and Professional Experience

Please send a document listing postsecondary schools attended and degrees earned or in progress to Elder Ernie Bridges at  erniebridges2@gmail.com.  Please include your employment history since adulthood starting with the most recent.  The document should provide 1) name of employer, 2) position held, and 3) dates of employment.

Note: if you do not send the requisite materials, your application will not be reviewed. 

Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy