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Board Member Application

Name

First Name *

Last Name *

Street Address

Supplemental Address

City

Zip Code

Country

State

Email *

Who referred you to apply to COIPP’s board?

In the space below, please tell us why you are interested in COIPP Board membership.

Areas of Expertise/Interest

Accounting

Administration (office, school, etc.)

Arts

Board Leadership

Budgeting and Budget Control

Developing and Influencing Policy

Education

Event Organizing

Executive Experience

Financial Management

Fundraising

Grants

Human Resources

Law Enforcement

Lawyer

Marketing

Public Relations

Social Media

Strategic Planning

Technology

Other

Relevant Employment History

Employer 1

Employer Name

Relevant Job Duties

Start Date

End Date

Employer 2

Employer Name

Relevant Job Duties

Start Date

End Date

Relevant Education and Training

Education/training

Current professional licenses or certifications that you hold

Previous Board experience (organizations)

References

List two non-relatives who would be willing to provide a reference for you.

Reference 1

First Name

Last Name

Contact Number

Email

Relationship

Reference 2

First Name

Last Name

Contact Number

Email

Relationship

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PRIVACY POLICY – TERMS OF SERVICE

CHILDREN OF INCARCERATED PARENTS PARTNERSHIP, 22 South Market Street, Suite 101 A, Frederick, MD, 21701

240-578-5662 info@coipp.org