Bike Walk Connecticut Board Member Interest Form

Important Documents

Board Member Agreement (PDF)
BWCT Bylaws (PDF)
Key Questions to Ask Before Joining a Board from BoardSource (URL)

Question Title

* 1. Contact Info

Name

Address

Address 2

City/Town

State

ZIP Code

Email Address

Phone Number

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* 2. Employment

Employer (if applicable)

Town where you're employed (if applicable)

Question Title

* 3. Are you a member of Bike Walk Connecticut? Learn more and join via our website.

Yes

We want to maintain diversity on our board and we seek board members with diverse backgrounds, of different ages, from all parts of the state and with a variety of skills.

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* 4. Gender

Question Title

* 5. Please describe your race/ethnicity.

Question Title

* 6. What is your age group?

17 or younger

18-20

21-29

30-39

40-49

50-59

60-69

70 or older