Committee Application

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CommitteeApplication

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Personal Information

Name:*

Home Address:

Employer:

Title:

Work Address:

Home Phone:

Work Phone:

Cell Phone:

Email:

Preferred Contact:

HomeWorkCellEmail

What skills / education or experience do you have

Accounting:

Education:

Management:

Investment:

Planning:

Advocacy:

Fundraising:

Knowledge of Service:

Marketing:

Technology:

Public Speaking:

Human Resources:

Health Care:

Community Relations:

Knowledge of Organization:

Other (please elaborate):

Which committee are you interested in

Personnel:

Membership & Bylaws:

Building Management:

Endowment:

Program:

Finance:

Resource:

Shelter Shop:

Monroe County Outreach:

Randolph County Outreach:

Additional Background

Describe committee/board or charitable experience:

Describe why you want to serve on this committee:

For statistical purposes-not required but helpful

Age:

Race/Ethnic Background:

* required

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