Candidate Profile Form printable pdf download

SELF HELP INC. BOARD OF DIRECTORS

CANDIDATE PROFILE FORM

Name_______________________________________________________________________________

Home Address_______________________________________________________________________

City__________________________ State_____________________ Zip Code____________________

Home Phone Number____________________________ Work Phone Number___________________

Fax Number____________________________________ Email Address________________________

Current Occupation___________________________________________________________________

Prior Work Experience________________________________________________________________

Education___________________________________________________________________________

Gender_________________________Age__________________Ethnicity_______________________

Relationship to SHI (family members employed; volunteer work; participation in projects)

____________________________________________________________________________________

Any experience as a Boards member?

____________________________________________________________________________________

Community / Volunteer Services

____________________________________________________________________________________

Civic/Professional Associations________________________________________________________

___________________________________________________________________________________

____________________________________________________________________________________

Interests____________________________________________________________________________

References__________________________________________________________________________

____________________________________________________________________________________

Date of availability for Board Service____________________________________________________

Candidate Profile Form