Application for Election to the Board of Directors

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* 1. Name

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* 2. Phone number

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* 3. Email address

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* 4. Address

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* 5. Occupation

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* 6. Your background

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* 7. What skills would you contribute to our Board?

Business

Children's services

Cultural diversity

Fundraising

Governance

Health care

Human Resources

Legal

Lived experience - family advocate

Lived experience - self-advocate

Property management

Public relations/media

Seniors' services

Social work

Other (please specify)

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* 8. What other Boards have you served on?

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* 9. Are you willing to commit to a three-year term?

Yes

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* 10. Can you regularly attend Board meetings?

Yes

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* 11. Can you commit to one Board and one Committee meeting per month and complete preparation work?

Yes

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* 12. Are you available for day and evening meetings?

Yes

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* 13. What is your interest in Community Living Parry Sound?

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* 14. Reference #1

Name

Phone number

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* 15. Reference #2

Name

Phone number

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* 16. Reference #3

Name

Phone number

A criminal reference check is required and will be coordinated by Community Living Parry Sound.

Application for Election to the Board of Directors

Question Title

* 1. Name

Question Title

* 2. Phone number

Question Title

* 3. Email address

Question Title

* 4. Address

Question Title

* 5. Occupation

Question Title

* 6. Your background

Question Title

* 7. What skills would you contribute to our Board?

Question Title

* 8. What other Boards have you served on?

Question Title

* 9. Are you willing to commit to a three-year term?

Question Title

* 10. Can you regularly attend Board meetings?

Question Title

* 11. Can you commit to one Board and one Committee meeting per month and complete preparation work?

Question Title

* 12. Are you available for day and evening meetings?

Question Title

* 13. What is your interest in Community Living Parry Sound?

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* 14. Reference #1

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* 15. Reference #2

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* 16. Reference #3

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* 17. Signature (please type your name if completing online)