Board Member Referral Form

BOARD MEMBER REFERRAL FORM

Prospective Board Member Information Sheet

* Indicates required field

Name *

First

Last

Title *

Organization *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Telephone *

Email *

Source of Referral/Information: *

Special Skills *

Fund-raising Personnel/Human Resources Finances Business Marketing/Public Relations Technology Legal Other

Professional Background *

For-profit business Government Nonprofit organization Other

Other affiliations *

Other board service *

Known levels of giving or volunteering *

Other pertinent information *

Submit

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