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Board of Directors Application
First name
Last name
Address
Country/Region
Address
City
Zip / Postal code
Email
Primary Phone
Secondary Phone
Company name
Position
Why are you interested in applying for a position on our Board of Directors?
Please list any involvement you have had with PCSCC:
Please list your involvement with other Boards of Directors:
What are you committed to contributing to PCSCC?
Are you able and willing to serve at least one term of 3 years?
YES
NO
Are you willing to recruit new Board members?
YES
NO
Are you willing to fundraise on behalf of PCSCC?
YES
NO
Would you consider being an Officer on our Board of Directors?
Chairperson
Vice Chairperson
Secretary
Treasurer
Would you be willing to serve on a PCSCC Committee?
YES
NO
Signature
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