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Committee/Board Application Form
Essence Of Mind
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Name
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Address (with zip code)
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Email
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Phone number
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Current or most recent job title (with employer name)
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Educational Background (degrees and dates)
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Are you passionate about Advocacy work? If so, please give examples:
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Are you available for meetings twice a month 7 pm? Days may vary as well location.
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Professional accomplishments and published works:
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Service on committees or other organizations:
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Statement of your job responsibilities relating to our committee:
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Are there any special contributions you can make to the work of Essence Of Mind?
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