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Cultural Diversity in the Arts
Empowerment Connection for Community Well-Being
Achievements
Home
Events & Programs
Programs
Cultural Diversity in the Arts
Empowerment Connection for Community Well-Being
Achievements
Potential Board Member Application
*
Indicates required field
Name
*
First
Last
Current Age Range
*
18-35
36-50
51 -65
over 65
Date of Birth
*
Race/ Ethnicity
*
Caucasian
Asian
African American
Hispanic / Latino
Native American
Other
Residence Address
*
Line 1
Line 2
City
State
Zip Code
Country
Date of Application
*
Email
*
Home Phone Number
*
Cellphone Number
*
Perferred Method of Contact
*
Work
Residence
Cellphone
Email
Are You Currently Employed
*
YES
NO
REIRED
Type of business or organization
*
Your title
*
Organization Representative or Educational Instition
*
Education/Training/Certificates
*
Work Phone Number
*
Work Address
*
Line 1
Line 2
City
State
Zip Code
Country
How do you feel LIFE, Inc. would benefit from your involvement with the organization?
*
Please list any groups, organizations or businesses that you could serve as a liaison to on behalf of LIFE, Inc.
*
Please tell us anything else you’d like to share about youself.
*
Optional – Have you received any awards or honors that you’d like to mention?
*
Do You Have A Disability
*
YES
NO
Skills, experience and interests (Please check all that apply)
*
Finance, accounting
Personnel, human resources
Administration, management
Nonprofit experience
Community service
Policy development
Program evaluation
Public relations, communications
Education, instruction
Special events
Grant writing
Fundraising
Outreach, advocacy
Independent Living
Legal
Boards and Committees which you have Served
*
Please list boards and committees that you serve on, or have served on (business, civic, community, fraternal, political, professional, recreational, religious, social).
Thank you very much for applying
If possible, please forward a copy of your resume to
[email protected]
Submit
