Board of Directors Candidate Application

Contact Information

Name*

Address*

Phone Number*

Email*

Employer Information

Company Name

Job Title

Type of Organization

Primary service(s) and area/population served

Work Address*

Work Email

Preferred method of contact

Work
Residence

Interests

Skills, experience and interests

(Please select all that apply)

Committee involvement

Please list boards and committees that you serve on, or have served on

(business, civic, community, fraternal, political, professional, recreational, religious, and social).
Please include: Organization, Role/Title, and Dates of Service

Special Skills or Qualifications/ Education, Training, Certificates

Summarize special skills, qualifications and education

Board of Director Participation

Are you able to commit to 2-3 hours per/month for meetings and volunteer commitments?

Yes
No
Maybe

How do you feel Wishbone Foundation would benefit from your involvement on the Board of Directors?

Please list any groups, organizations or businesses that you could serve as a liaison to on behalf of Wishbone Foundation.

Please tell us anything else you’d like to share.

Agreement*

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a board member, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

I Agree

Name

First Last

Our Policy

It is the policy of Wishbone Foundation to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.
Thank you for completing this application form and for your interest in Wishbone Foundation.

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