Board of Directors Application

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Date of Birth *

MM

DD

YYYY

Please tell us about your special skills or interest? Please highlight those that apply. *

Administrative, Office, Financial

Food Safe Certified

Serving it Right Certified

Labour Skills, Facilities Maintenance

Community Programs (Film Club, Rec & Roll etc)

Social Media

Fundraising

Promotional, Writing

Other (Please Describe Below)

How often would you like to contribute? Please highlight those that apply.

Days

Evenings

Weekends

Weekly

Monthly

Special Events Only

Why do you want to volunteer with the Cowichan Station Area Association. Please highlight those that apply.

Academic Credit

Social Interaction

Share my Skills

Support the Community & Cause

Learn New Skills

Gain Employment Skills

Stay Active

Other (Please Describe Below)

CSAA often takes photos of our volunteers at work to help promote our projects and attract support. Do we have your permission to publish photographs in which you appear?

Yes

No