BOARD MEMBER APPLICATION Please complete the form below to apply to become board member. Applicant Information Name of applicant First Name * Last Name * Preferred Mailing Address Address Line 1 * Address Line 2 City * State * Select option... Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming DC Zip/Postal Code * Phone Number * E-mail * Languages you speak fluently: * Business Information Name of Company/Organization * Your Title * Applicant Experience Organization Role/Title And Years of Service Please provide information on different boards and committees that you serve on, or have served on (if any). For Example: business, civic, community, fraternal, political, professional, recreational, religious, and social. Why do you want to be a member of the Board of Directors? Please describe both personal and business goals. * What special talents do you have that you can bring, and/or in what capacities have you volunteered so far for the Solano Hispanic Chamber? * Start with your top skills and experience Other current Solano County community organization involvement Chamber Member References * Attach any additional pages - Attach Resume (optional) PHOTO RELEASE: I hereby grant SHCC and any contracted Photographer, the unrestricted and irrevocable right and permission with respect to the photographs and/or video taken of me or in which I may be included with others to use, reuse, publish, and republish the same, whole or in part, separately or in conjunction with any and all media now and hereafter known for illustration, art, promotion, advertising, trade, editorial, or any other purpose whatsoever, without restriction as to alternation and use my name in conjunction. Entering your full name below acts as your e-signature to the Photo Release * Enter Your Full Name Enter today's date * Format: MM/dd/yy
