First Name*

Last Name*

Email*

Please list your full address including city, state, and zip code*

City*

State/Province:*

Zip/Postal Code:*

Phone Number:*

Employer

Work Email

Work Address

Type of Business or Organization

Preferred Contact

Experience: Please list boards, committees that you serve on, or have served on (business, civic, community, fraternal, political, professional, recreational, religious, and/or social).

Organization

Role/Title

Dates of Service Start

Dates of Service End

Organization 2

Role/Title 2

Dates of Service Start

Dates of Service End

Organization 3

Role/Title 3

Dates of Service Start

Dates of Service End

Other Organization with which you are associated:

How do you feel Cedar Valley Pit Bull Rescue would benefit from your involvement on the Board? *

What are your skills, experience and interests?
Choose all that apply: Finance, accounting Personnel, human resources Administration, management Nonprofit experience Community service Policy development Program evaluation Public relations, communications Education, instruction Special events Grant writing Fundraising Outreach, advocacy, Other

What interests you about working with Cedar Valley Pit Bull Rescue?*

Please tell us anything else you'd like to share. For example, how did you hear about us, did you have an experience with us previously, etc.)

Reference 1, Please include phone, email, and address.*

Reference 2, Please include phone, email, and address.

Reference 3, Please include phone, email, and address.