Board Information Form

Please enter your information below.

Personal Information
First Name
Middle Name
Last Name
Preferred Name
Cellphone Number
Birthdate
Date Format: MM slash DD slash YYYY
Professional Information (if applicable)
Company Name
Professional Title
Company Street Address
Company City
Company State
Company Zip Code
Business Phone Number
Preferred Email
Should your assistant receive calendar invitations for you?
- Yes
- No
- Not Applicable
Assistant Name
Assistant Email
Residential Information
Residence Street Address
Residence City
Residence State
Residence Zip Code
Home Phone Number
Spouse or Partner Name (if applicable)
I prefer to receive mail at:
- Home
- Work
Other Information
Present and past board affiliations (including dates of service):
Present and past civic and charitable affiliations (including dates of service):
Talents, abilities and experiences that would be helpful to Park Pride (fundraising, public relations, strategic planning, financial skills, legal skills, project experience, etc.):
Comments
This field is for validation purposes and should be left unchanged.

Personal Information