Board Member Application

 

Name    _________________________________________              DOB:  ____/_____/_____

(Please place a Ö in the box beside the address, phone, fax and email you would like us to use)

     Home Address:

 

__________________________________

    Home Phone:  ________________________

__________________________________

     Home Fax:  __________________________

__________________________________

     Home Email:  ________________________

 

 

     Work Address:

 

__________________________________

    Work Phone:  ________________________

__________________________________

     Work Fax:  __________________________

__________________________________

      Work Email:  ________________________

 

 

Spouse:  __________________________________________

Children/Ages:  __________________________________________________________________

Affiliations

Education

High School: _____________________________________________________  Class of ________

Undergraduate:  __________________________________________________   Class of ________

Graduate:  ______________________________________________________    Class of ________

Other:  _________________________________________________________    Year ___________

Business/Civic/Social Clubs (Please list any offices held or awards received)

________________________________________________________________________________

________________________________________________________________________________

Religious Affiliations (Church/Synagogue/Mosque/Temple membership):_____________________

_______________________________________________________________________________

Board Memberships (Current and Past.  Please list years of involvement). ___________________

_______________________________________________________________________________

 

Political Contacts:_____________________________________________________________

 

 

 

 

1)    What nonprofit or volunteer activities have you been involved with?

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

2)    How do you feel you can benefit Urban Life Training through your role as a board member?

                                                                                                                                                           

                                                                                                                                                           

 

3)    What particular issue, opportunity or problem do you feel is crucial in helping Urban Life Training?

                                                                                                                                                           

                                                                                                                                                           

4)  Do you agree that abstinence from sex before marriage is the healthiest choice for young people?  Please explain.
                                                                                                                                                                          

                                                                                                                                                                          

                                                                                                                                                                          

 

4)    What role do you feel the board of directors should play in the work of Urban Life Training?

                                                                                                                                                           

                                                                                                                                                           

 

5)    What excites you about the work of Urban Life Training?

                                                                                                                                                           

                                                                                                                                                           

 

6)    Nonprofit Organization References:

 

                Name/Relationship                                    Address/Phone Number    

                                                                                                                                                        

                                                                                                                                                        

                                                                                                                                                        

     

                                                                                                                                                        

                                                                                                                                                        

                                                                                                                                                        

                                                           

                                                                                                                                                        

                           Signature of Applicant                                                                               Date           

 

                                                                                    

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