Board of Directors Interest Form
Contact Information
Name
Home Address
Town, State, Zip
Home Phone
Fax
Email
Business/Employer
Title
Address
Town, State, Zip
Phone
Fax
Web
Demographic Information
Age
Choose one...
18-21
22+
Race/Ethnicity
American Indian
Asian/Pasific Islander
Black
Hispanic
White
Bi-Racial
Other
Gender
Male
Female
Skills/Experience
(check all that apply)
Management
Retail
Board Development
Finance
Accounting
Strategic Planning
Business Development
Insurance
Fundraising
Legal
Human Resources
Teaching/Facilitation
Sales/Marketing
Banking
Youth Development
Hobbies/Interests
Learned about YES from
Where did you learn about YES?
YES Board Member
YES Staff
Friend
Family Member
Colleague
Newspaper/TV/Radio
Event
Internet
YES Literature
Why are you interested in being a YES director?
Security Code:
6173790
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