Board Application Form

"*" indicates required fields

Full Name*

Street/Box #*

Town/City*

Postal Code*

Phone*

Email*

Street/Box #

Town/City

Postal Code

Phone

Email

Occupation

Where do you want correspondence sent?

Previous Volunteer Experience*

(Memberships in Service Clubs, Social Clubs, Churches, etc. & Office Held)

In your previous volunteer work what did you enjoy most?*

What did you enjoy least?*

How much time can you give to SCCR?*

Have you ever been asked to resign from a volunteer position*

Yes

No

Why?*

What are your reasons for putting forth your name to join our Board?*

After reviewing the Board Committees, please indicate what Committee(s) you would like to serve on?*

Policy, Program and Personnel Committee

Finance Committee

Fundraising Committee

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