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Board Nomination Form

Four Mile Board Nomination

Date(Required)

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

County of Residence(Required)

Phone(Required)

Email(Required)

Gender - Please select from the menu below:(Required)

Race - Please select from the menu below:(Required)

Reference 1

Name(Required)

First Last

Phone(Required)

Email(Required)

Reference 2

Name(Required)

First Last

Phone(Required)

Email(Required)

Reference 3

Name(Required)

First Last

Phone(Required)

Email(Required)

Areas of Expertise(Required)

Accounting

Animal Care

Education

Fundraising/Development

History/House Museums

Law

Marketing

Other - Please Explain

Why are you interested in joining the Four Mile Historic Park Board of Directors?(Required)

What value would you bring to Four Mile Historic Park?(Required)

Upload Current Resume(Required)

Max. file size: 64 MB.