1. Candidate Name _____________________________________________________
Mailing Address _____________________________________________________
City __________________________ State _______ Zip _________
Home-phone_____________ Work-phone____________ Email_______________________
2. Current position/employer: _____________________________________________________
3. Please circle area(s) of expertise/contribution you feel you can make to further the mission of FTAA:
Fundraising Special Events Membership Legal Expertise Financial Expertise
Website Newsletter Education Cultural Activities
4. Please list prior experience serving as a Board member for any other non-profit organizations:
5. Why are you interested in serving as a Board member for FTAA?
6. Please share any other information you feel important for consideration of your application to
serve as an FTAA Board member.
7. Please name and phone no. of any FTAA member as reference:____________________________
Signature: Date:
___________________________________________________________________________________
OFFICE USE:
08Dec