Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone Number *

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Work Phone Number

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Board Positions (select all positions you are interested in)

Chair

Program

Treasurer

Marketing

Secretary

Kitchen

Site

Skills and Experience *

Finance, Accounting

Grant Writing

Fundraising & Special Events

Public Relations, Communications

Management, Administration

Nonprofit Experience

Teaching Experience

Curriculum Development

Contacts, Networking

Other