EmailMe Form - Board Member Application

Name *

First Last

Address

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

Email

Phone Number

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

Please describe your education, including field of study, degrees, professional licenses/certifications, etc. *

Describe any prior community service or vounteer work that you have done. (Also list any other boards that you serve on.) *

What do you know about REACH Council, and why do you want to serve on the board of directors? *

Please tell us about your personal qualities, and how you feel you will be able to positively contribute to the board. *

Photo/Video Release *

I Agree

By clicking the "I Agree" button above, you confirm that you understand that REACH Council frequently takes photographs and/or videos during our events, programs and presentations, and that you may be featured in such photos or videos. You further agree that you authorize REACH to use those photographs or videos without restriction or compensation to you, including but not limited to, newspaper print, website publication, etc.

Board Committment *

I Agree

By clicking the "I Agree" button above you understand the role that you would play as a voting member of the REACH board of directors. You further agree to participate in board training, actively participate in fundraising events, disclose any conflict of interest, and fully support the REACH mission.

Resume

If you have a resume or CV, please upload it here. File types .pdf, .doc or .docx are acceptable.

References

If you have a list of personal or professional references, please upload it here. File types .pdf, .doc or .docx are acceptable.