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* 1. Please provide your contact information.

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* 2. Are you a current club member?

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* 3. In what year did you join LHC? (enter 4-digit year; for example, 2010)

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* 4. What Positions are you interested in? (You may select multiple positions)

* these positions are completing their second year of their term

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* 5. Please state in your own words why you would like to be a board member, including any experience and benefits this would bring to the club.

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* 6. Electronic Signature: (please type your complete name)

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* 7. In order for my application to be considered, I agree to obtain 15 signatures if I am a current member and 30 signatures if I am not a current member. Signature pages can be brought with you to the interview.

http://assets.ngin.com/attachments/document/0054/8804/signature_page.doc

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