Apply to the Board

Thank you for your interest in joining the C89.5 KNHC Public Radio Association Board of Directors. Please fill out and submit this form. Please allow 5 to 10 business days for a response.

Name

First

Last

Phone Number

Email (for KNHC communication)

Street Address

City, State, ZIP

City, State, Zip

Employer

Place of Employment

Occupation / Title

Employer Street Address

Street Address

Employer City, State, Zip

City, State, Zip

Employer Phone

Phone

people Employer (other

Employer Email

Email

Professional and Service Highlights

Please list highlights of your professional employment, community service, educational background and personal and professional affiliations

Applicant Questions

What do you consider the contribution KNHC DANCE 89.5 radio makes to our Community?

Applicant Questions #2 (why are you interested)

What about the work of the KNHC Board is of interest to you and why are you interested in serving on this Board?

Applicant Questions #3 (how will you help)

Please explain how your participation would help this board fulfill its obligations and best do its Work?

Applicant Questions #4 (other board experience)

If you checked "Non-profit board experience" above, list the names of the boards you have served or are serving through your participation

Applicant Questions #5 (what have we missed)

What have we missed? Please describe any other special interests, skills, experience, expertise not listed above

First Reference, if you have committee or board experience, please include people familiar with your work on them

First

Last

First Reference Phone

Phone

First Reference Phone Type

Home
Mobile
Work

First Reference Email

Email

First Reference How Known

How known

Second Reference, if you have committee or board experience, please include people familiar with your work on them

First

Last

Second Reference Phone

Phone

Second Reference Phone Type

Home
Mobile
Work

Second Reference Email

Email

Second Reference How Known

How known

Applicant Agreement

I confirm that if selected, I will fulfill the responsibilities and expectations of a C89.5 / KNHC Public Radio Association Board Member and disclose any direct or indirect conflicts of interest. I further confirm that I have reviewed the Board Member Job Description, and the KNHC Foundation By-Laws, and am eligible to serve as a Board Member under the criteria set forth therein.

DANCE 89.5 DANCE 89.5

Apply to the Board

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