Board of Directors Application Name(Required) First Last Business Name(Required)Type of Business(Required)Email(Required) Phone Numbers(Required)NumberType (Cell, Home, Work, etc.) Add RemoveBusiness Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please provide a brief statement of your professional career, interests and hobbies(Required)How do you feel Scotts Valley Chamber would benefit from your involvement on the Board?(Required)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 Add RemovePlease list any groups, organizations or businesses that you could serve as a liaison to on behalf of Scotts Valley Chamber of Commerce. Add RemovePlease 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 EmailThis field is for validation purposes and should be left unchanged. Δ
