* First Name
* Last Name
* Address
Apt. # or Unit
* City
* State
* Zip Code
* Phone Number
Alternate Phone Number
* Email
Why are you interested in serving on CPAC’s board of Directors?
Do you currently serve on a board of directors? If so, what board activities are you engaged with? Does this include officer experience?
What professional skills would you bring to the CPAC Board (eg, fundraising, strategic planning, marketing, finance, education planning, community outreach, etc.)?
CPAC board members are required to attend a minimum of 10 monthly board meetings and to serve on at least one committee, resulting in a time commitment of at least 6 hours/month. Do you see this as an issue with your schedule?
YesNo
CPAC board members are asked to make an annual cash or in-kind contribution of $1000 during each year of their board tenure. Are you able to make this commitment?
Reference #1
Reference #2
Reference #3 (optional)
Is there any additional background information that you would like to share with us?