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* 1. First & Last Name:

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* 2. Personal Email:

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* 3. Home Address:

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* 4. Home/Cell Phone:

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* 5. Applicant Employer:

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* 6. Position Title:

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* 7. Employer Address:

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* 8. Work Email:

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* 9. Work Phone:

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* 10. Years with Business:

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* 11. Do you have any previous Chamber involvement?

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* 12. I have served on a committee with the Menomonie Area Chamber.

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* 13. I have served on the following committee:

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* 14. I have been involved with the Menomonie Area Chamber in the following ways:

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* 15. I have served on a Board/committee with another Chamber.

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* 16. Which other Chamber have you been involved with?

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* 17. Please provide a brief biography including your background and interests.

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* 18. Why are you interested in serving on the Menomonie Area Chamber & Visitor Center's Board of Directors?

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* 19. Please describe skills or specific areas of expertise that you could contribute to the Menomonie Area Chamber & Visitor Center Board/team.

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* 20. Please describe any potential conflicts of interest with serving on the Menomonie Area Chamber's Board of Directors.

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* 21. Please list other forms of personal/professional community involvement, including information about other committees/Boards you have served on or currently serve on.

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* 22. Once this application is complete, it will be shared with the Chamber CEO.  The Chamber CEO then distributes applications to the Nominating Committee for consideration.  A committee member will contact you by phone/email in accordance with the application process timeline.  Questions should be directed to ceo@menomoniechamber.org or 715-235-9087.  

By electronically providing my first and last name below, I acknowledge that I have reviewed the Board of Directors eligibility, qualifications and commitments.  

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