Safe Passage Board Application
Prospective Board Member Application
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Email *
Name *
Address *
Phone Number *
Occupation/Profession *
Current Employer *
Educational background, areas of specialized training, expertise, experience *
Present membership on other Nonprofit Boards of Directors: *
If yes above, please list organizations, date terms began and end, and offices held:
Participation in other civic activities: please list civic activities and affiliations such as church membership, service organizations, and any offices held or special responsibility in the activity listed:
Why are you interested in serving on our Board of Directors? *
How do you feel you could serve or help the agency as a Board Director? *
How much time, not counting monthly Board meetings, can you contribute each month? *
Each Board Director serves on one or two committees. Which committees are you interested in? *
In addition, each Board Director is expected to participate in the agency's fundraising efforts. How can you help? (Check all that apply.) *
How did you learn about this Board position? *
Other comments:
Signature *
Date *
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