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* 1. First and Last Name

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* 2. Phone Number

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* 3. Email

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* 4. NAWBO Chapter

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* 5. Current Membership Status

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* 6. On what Board Committee are you interested in serving?

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* 7. Why are you interested in serving on this Board Committee?

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* 8. What talents, experience, or expertise will you bring to this Board Committee?

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* 9. What has been your involvement in your local chapter over the past five years?

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* 10. Identify one reference from NAWBO and include her name, chapter, email, and telephone contact information.  Tell us why you chose her as a reference.

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* 11. Identify one business or community reference who is not associated with NAWBO and include his/her name, email, and telephone contact information.  Tell us why you chose him or her as a reference.

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* 12. Tell us a little about yourself (limit 100 words)

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