Boardmember Application

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Home
About Us
Partnerships & Resources
Donation/ Fundraising
Events & Programs
SPONSORS
Photo Gallery
Achievements
Newsletters

Potential Board Member Application

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Date *

Email *

Home Phone Number *

Cellphone Number *

Perferred Method of Contact *

Work Residence Cellphone Email

Your title *

Type of business or organization *

Organization Representative or Educational Instition *

Work Phone Number *

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? *

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

Boards and Committees *

Please list boards and committees that you serve on, or have served on (business, civic, community, fraternal, political, professional, recreational, religious, social).

Education/Training/Certificates *

Thank you very much for applying
If possible, please forward a copy of your resume to denise.thomas@life-mdinc.org

Submit

LIFE, Inc. is a 501(c)(3) organization
15800 Crabbs Branch Way, Suite 300
Rockville, Maryland 20855
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(240 ) 503-3328