EmailMe Form - Community Board application

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Personal Information

Phone Number *

### - ### - ####

Email *

Are you willing to attend regular meetings with The Times' Editorial Board? *

Yes

No

Verify that you are over the age of 18? *

Yes

Please briefly explain why you'd like to join our Community Board. *

EDUCATION

Select all that apply

I certify that information contained in this application is true and complete. I understand that this application is not a guarantee of final selection and only an expression of my interest in participation. I authorize the verification of any or all information listed above.

Do you agree with the terms and conditions? *

Yes, I agree.

Date *

MM / DD / YYYY