Board Candidate Application "*" indicates required fields Step 1 of 5 20% Contact InformationName* First Last Email* Phone*Home Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Previous ExperienceCurrent Occupation* Areas of Expertise*Please check all that apply. Business / corporate Financial management Volunteer management Nonprofit management Human resources Public speaking Public relations / marketing Philanthropy Education Legal Fundraising Government Please provide details on any other areas of expertise and skills.Please provide details on any previous board experience(s).Please provide details on any other community and volunteer service(s).Please provide details on any membership(s) in civic and professional associations.Please provide details on any special interests and hobbies. Interest in FCCASHow did you learn about FCCAS?* Current relationship to FCCAS?What areas of the FCCAS Board of Directors are of interest to you?*How many hours per month do you anticipate being able to spend on the work of the FCCAS Board of Directors?* Date of availability for FCCAS Board service.* MM slash DD slash YYYY ReferencesPlease supply two references. At least one should be from someone with whom you have worked in an employment capacity or as part of a group. (Note: references will not be contacted until after you meet with the Board President and Shelter Administrator.) Reference 1Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone* Reference 2Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone* SignaturePlease allow my name to stand for nomination to the FCCAS Board of Directors. I am eager to commit my time, energy, and passion to Friends of the Cuyahoga County Animal Shelter.Signature*Date* MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged.
