Steering Committee Application

Please leave this field empty. Date Name Prefix Sufix Employer Phone Does this number receive text? YesNo Email Mailing Address Identify the sector(s) you most closely associate with (check all that apply) Behavioral HealthBusinessEducationExperienced HomelessnessFinancial InstitutionFundingGovernmentHealthcareLegalNonprofitReal EstateSocial ServicesOther Do you have 2-4 hours a month to dedicate to the committee’s work? YesNo List all current professional affiliations, boards, committees, and volunteer positions. Why are you considering membership to the Steering Committee? Describe the skills or expertise you bring to the Steering Committee. Be specific and elaborate.