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* 1. Are you interested in an Officer role? If so, please indicate which

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* 2. We are also seeking a Parliamentarian, a legal professional specializing in Non-profit. Please indicate if you or someone you know may be a good fit to advise us on non-profit compliance, by-laws, and other legal matters

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* 3. We are seeking Advisory and Action committee members. Each committee would be comprised of at least one committee chair who has professional experience in a related field to lead/facilitate members of that committee who represent a diverse cross-section of stakeholders. Please check the committees you would be interested in contributing your time, energy, and talents to. If you are interested in chairing a committee, please indicate that below:

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* 4. Name

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* 5. Email

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* 6. Phone

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* 7. Anything else you would like to share?

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