Board of Directors Application

Name*
First Last
Busiess Name*
Type of Business*
Email*
Phone Numbers*
Number Type (Cell, Home, Work, etc.)
Business Address*
Street Address Address Line 2 City State ZIP Code
Please provide a brief statement of your professional career, interests and hobbies*
How do you feel Scotts Valley Chamber would benefit from your involvement on the Board?*
Please list boards and committees that you serve on, or have served on (business, civic, community, fraternal, political, professional, recreational, religious, and social).
Organization Role/Title Dates of Service
Please list any groups, organizations or businesses that you could serve as a liaison to on behalf of Scotts Valley Chamber of Commerce.
Please check the Chamber events in which you would like to volunteer, or committees you would like to serve on or chair:
- Art Wine & Beer Festival
- Community Awards Gala
- Economic Development Task Force
- Events Committee
- Marketing Committee
- Membership Committee
Signature*
I have read the Scotts Valley Chamber Policies, Procedures and By-Laws. I agree to abide by these policies, to attend the scheduled meetings of the Chamber Board of Directors and to volunteer for and participate in the activities and events sponsored by the Chamber.

Number	Type (Cell, Home, Work, etc.)

Organization	Role/Title	Dates of Service