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