Board of Directors Member Interest Form

If you’re interested in exploring board service, we’d love to learn more about you.

Our board seeks individuals who bring strategic insight, community perspective, and lived experience to complement our existing strengths in compliance and financial stewardship.

Whether your background is in behavioral health, recovery, culturally specific community leadership, policy, technology, workforce strategy, or cross‑sector collaboration, your perspective may be a strong fit for our mission.

Please fill out the form below, including your background, areas of expertise, or motivation for serving.

Board of Directors Member Interest Form

Applicant

Name
Occupation / Title
Email Address
Work Phone
Cell Phone

Organization

Name of Business / Employer / CBO / Labor Organization of Employees
Website
Address

Qualifications

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