Board of Directors Application Board of Directors Application Name* First Last Busiess Name*Type of Business*Email* Phone Numbers*NumberType (Cell, Home, Work, etc.) Business Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific 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).OrganizationRole/TitleDates 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: Education Committee Art & Wine Festival Marketing Committee Government Affairs Committee Awards Gala Membership Committee Christmas Tree Lighting Festival 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.