YOUR BACKGROUND
What education or skills could you contribute to our board? (Please check)
___Accounting     ___Management    ___ Church Relations      ___Investment     ___Marketing

___Fundraising     ___Education         ___ Public Speaker         ___Community Relations

___ Planning         ___Motivated          ___Ministry                     ___Affiliations
___Other (Please explain) _____________________________________________________

What other boards have you served?____________________________________________

Charitable or community activities in which you have been involved ____________________

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YOUR AVAILABILITY TO SERVE
Could you regularly attend board meetings? ____Yes ____ No ____ Conflicts

How many hours per month, in addition to board meetings, could you serve? ____________
Would you attend a training session for new board members? ___Yes ___No

YOUR VIEWS ON OUR ORGANIZATION (Use additional pages for additional comments)

What is your interest in this organization?_________________________________________

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Please write a brief statement of your understanding of the mission of the organization

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REFERENCES (List names, addresses, and phone numbers)

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Signature_____________________________________________ Date_________________