Board of Directors Member Application

Basic Information

Full Name

Home Address

Home City

Home State

Home Zip

Home Phone

Cellular Phone

Email Address

Employer

Employer Address

Employer City

Employer State

Employer Zip

Expertise

Area	Interest	Expertise
Finance
Human Resources
Business Mgmt.
Nonprofit Experience
Community Service
PR/Marketing
Fundraising
Government Relations
Outreach/Advocacy
Legal
I/DD Community

Other Interest

Other Expertise

Board Experience

Organization	Role / Title	Dates of Services

What month did you attend a Board meeting?

Please summarize your history with DDRC, if applicable.

Please summarize why you are interested in serving as a Board member for DDRC.

Please share any other information you feel important for consideration of your application to serve as a DDRC Board member.

Nominations will be reviewed for current and upcoming vacancies and will be maintained for future consideration. Thank you for your interest in serving on the DDRC Board of Directors.