I Am A Safe Place

Board Member Application

Domestic Violence Awareness, Education, and Prevention Non-Profit Organization.

Board Member Application

First Name

Last Name

Phone Number

Address

City

State

Zip Code

Date of Birth

Race

Gender

Male

Female

Other

Current Occupation

Employer

Why Are You Interested In Serving On This Board?

What Skills Or Expertise Do You Bring To The Board

Do You Have Previous Experience With Domestic Violence Awareness, Education, Or Prevention Initiatives?

Please Attach Resume And Or Relevant Document's

Choose File

Are You Willing To Commit To Attending Regular Board Meetings And Participating In Events And Initiatives?

Yes

Maybe

Availability Details

Reference 1 Relation

Reference 1 Phone

Reference 1 Name

Reference 2 Relation

Reference 2 Phone

Reference 1 Name