Community Advisory Board (CAB) Member Application

Name *

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Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Preferred Contact Method *

Phone
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Email

1. In order to accomplish the CAB’s objectives, full participation of each member is necessary. Board members serve a term of at least two years. The CAB meets monthly on dates that are predetermined by members. Interim meetings are occasionally scheduled when necessary. Can you make this time commitment? *

2. List neighborhood, community, civic, professional, business, religious, social, athletic, or other organizations of which you are or have been a member. List the role you held with each affiliation. *

3. Please indicate in which, if any, of the following areas you have experience: *

4. Language(s) spoken *

5. Why do you want to be a member of the CAB? What would make you an effective member of the Community Advisory Board? *

6. In your opinion, what are the two most pressing issues facing Baltimore today? *

7. To ensure that there is not a conflict of interest, please provide the name of your employer and your position. Community Advisory Board members cannot have any financial relationship with Family League of Baltimore. *

8. REFERENCES: Please list two personal or professional references that we may contact. *

First

Last

Reference 1: Email *

Reference 1: Phone *

Reference 1: Relationship *

Reference 2: Name *

First

Last

Reference 2: Email *

Reference 2: Phone *

Reference 2: Relationship *

ACKNOWLEDGEMENT: All information provided, to my knowledge, is correct and true. I grant permission for my responses and references to be verified by applicable member(s) of the selection committee. I understand that completion of this application does not ensure a candidate’s acceptance to the Community Advisory Board (CAB). If selected, I will devote the time required as outlined in section one of this application. If, at any time or for any reason, I am unable to devote the time required as outlined in section one of this application, I will provide notice of my reasoning and/or resignation from the CAB within a reasonable amount of time. *

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