Join the Prosumer Board of Directors

Personal Information

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip Code *

Phone *

Email Address *

How long have you been a Prosumer? *

Are you a person with lived experience of mental health issues? *

Yes

What is it about Prosumers has you want to apply to be a Board Member

Availability

The Prosumer Board of Directors meets on the third Saturday every three months at 11:30 a.m. The meeting generally lasts about four (4) hour. Do you have any standing commitments that create a scheduling conflict for you? *

Yes

Mostly

Employment

Current Employer

Company Name 🛈

Address

Position

Phone

Questions

Please describe your relevant experience and/or employment. You may also attach a resume. *

Please describe the area(s) of expertise/contribution you feel you can make to further the mission of Prosumers *

Please list prior experience serving as a Board member for other non-profit organizations: *

What other volunteer commitments do you currently have? *

Why are you interested in serving as a Board member for Prosumers? *

References

Reference 1

Name

Title

Email Address

Phone

Reference 2

Name

Title

Email Address

Phone

Reference 3

Name

Title

Email Address

Phone

Additional Skills

Please share any other information you feel important for consideration of your application to serve as an Prosumers Board member.

Please submit a copy of your resume.