wear blue: run to remember

Board of Directors Application

* First Name

* Last Name

* Mobile Phone

* Address

* Email

* By whom were you referred?

Please attach resume below

Document

* Why are you interested in serving as a leader for wear blue: run to remember?

Employment Information

* Occupation

* Employer

* Business Address

* City

* State

* Postal Code

* Nature of Business

Racial Ethnicity (optional)

Gender (optional)

Relationship to Military (optional)

Preferences: When we contact you to send information, confirm meetings, etc., how do you wish us to contact you?

* Overall, what is your preferred method of contact?

* If we need to send physical mail from this office, how would you prefer to receive it?

If "other" above, please notate here

* What skills/contacts could you contribute to the Board?

If "other" above, what contributions?

Please list current and/or previous organizations (Rotary, Chamber, etc.) you are affiliated with, including volunteer board or leadership positions:

* Please include: Organization - Address - City/State - Office/Committee - Length of Service

* Please provide a brief biography (include relationship to military service if applicable, however military service is not required for Board membership)

* Signature of applicant

* Date