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Virginia Chapter Board Member Information
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What is your name as you would like it to appear?
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Your answer
My preferred public email address (to be shared outside the Board) is:
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Your answer
My preferred phone number (to be shared outside the Board) is:
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Your answer
My preferred internal email (to be used by AFSP staff & Board if different from public email) is:
Your answer
My preferred internal phone number (to be used by AFSP staff & Board if different from public phone) is:
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My mailing address is:
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Your answer
My preferred mode of communication is:
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Email
Text
Phone Call
Other:
Emergency Contact Name:
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Your answer
Emergency Contact Phone:
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Your answer
Emergency Contact Email:
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Your answer
Emergency Contact Relationship:
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Your answer
I need new/more AFSP Chapter Board business cards.
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Yes
No
My shirt size is:
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XS
S
M
L
XL
2X
3X
4X
My favorite snack(s) is/are:
Your answer
My favorite beverage is:
Your answer
I really, really love: (example, Kathe loves anything with dragonflies)
Your answer
I have been a board member for:
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< 1 year
1 year
2 years
3 years
4 years
5 years
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