Application for the Ad-hoc Commitee on African American Disparity

Question Title

* 1. Name

Question Title

* 2. Email

Question Title

* 3. Phone

Question Title

* 4. Street Address

Question Title

* 5. Zip Code

Question Title

* 6. What district do you live in?

District 1

District 2

District 3

District 4

District 5

I am unsure.

Question Title

* 7. My current career, job, or area of study is:

Question Title

* 8. Please share current employer, job title or school and major.

Question Title

* 9. Membership is a three-year commitment. Board members are required to attend monthy meetings (primarily on zoom) along with special events and programs across the year. Attendance is tracked. Missing meetings can mean dismissal. Are you able to commit to steady participation?

Yes

No

Question Title

* 10. Why are you interested in joining ACCAD?

Question Title

* 11. What skills and/or perspectives you bring:

Question Title

* 12. Please share what community organizations and/or boards where you are already a member.

Question Title

* 13. Please share more about yourself.