Board of Directors' Member Application Form

Your Name


Phone Number


Postal Code

List previous or current volunteer work.

List any Board Member experience(s).

On what types of committees do you see yourself serving?

Are you available for monthly meetings, held in Nanaimo every fourth Thursday, from 5:30 pm to 7:30 pm, with the exceptions of December, July, and August?

Please provide the name and phone number of a person we may contact, who you think is most knowledgeable of your abilities to serve as a Board Member.

Reference's Name

Reference's Phone Number

Please send us a resume via email, if possible.

I have provided a personal resume via email.

If a resume is not available, please include some information about your education and employment history in this application.

I am aware that a Criminal Record Check is required. Yes


I am aware that board meetings take place in Nanaimo. Yes


I have familiarized myself with the Roles and Responsibilities of Board Members. Yes


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