Committee Member Information

Candidate Information

Name*

First Last

Email*

Home Address*

Street Address Address Line 2 City Province Postal Code

Home Phone

Cell Phone

Candidate Biographical Information

Please describe your related experience or knowledge in the following areas. It is not expected that you will possess experience/knowledge in all areas.

Educational or Professional Designations

Work Experience

Board and/or Committee Experience

Public Relations and Communications

Fundraising and Special Events

Teaching Experience or Curriculum Development

Community Involvement and Other Interests

Committee*

Events
Government Relations
Membership Services
Professional Development

Please indicate which committee you are interested in.

Candidate Summary Statement*

Include what you would like the MBNLA Board of Directors know regarding your membership on a committee; skills, experiences, why you would like to serve on the Committee, etc. This statement, as received, or extracts of may be communicated to the Board of Directors as required.

Phone

This field is for validation purposes and should be left unchanged.