Sego Lily Board Member Application
Email address
Name:
Your answer
Address:
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Phone Number:
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Email Address:
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Date of Birth:
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SSN#:
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I understand to be on the Board and accordance with SLCAD’s liability insurance I must pass a criminal background investigation (BCI) and that the above information is needed to perform the BCI. SLCAD agrees not to disclose this information to anyone outside of SLCAD other than the BCI agency. (You may call the front office at 801 590 4020 to give your DOB & SSN if you're not comfortable sharing your personal information on this application form.it online)
Why I want to join the board?
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Areas of interest (roles on the board)
Other talents/skills I can contribute: (Example: technology; art; writing; social networking; leadership)
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