Name:
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Address:
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City/State/Zip:
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Email Address*:
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| Do you check your email on a regular basis?
Yes: No:
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Primary Phone:
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Secondary Phone:
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Date of Birth:
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Place of Work/Title:
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Do you have a Facebook account?
Yes: No:
Do you Follow the Museum on Facebook?
Yes: No:
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Do you have a Instagram account?
Yes: No:
Do you Follow the Museum on Instagram?
Yes: No:
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Please list all community organizations, committees, or non-profit organizations with whom you are currently or have previously been involved and how you contributed:
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Please summarize your professional background and how you can contribute professionally to the WCHA & Museum Board:
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Please explain your interest in joining the WCHA & Museum Board:
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Have you ever served as a WCHA & Museum Board member?
Yes: No:
If so, when and how long did you serve?
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Have your ever served on any WCHA & Museum committees?
Yes: No:
If so, when and which committee?
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Do you know a current Board or Committee member?
Yes: No:
If so, who?
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Have you ever attended a WCHA & Museum sponsored event such as exhibit openings, programs, or productions?
Yes: No:
If so, what event?
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At this time, the WCHA & Museum Board meets quarterly. Can you dedicate the time to attending these meetings?
Yes: No:
Meeting times are subject to change to best accommodate the majority. What are dates/times that you are regularly available to attend meetings?
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Do you have any previous experience in:
• Archival & Preservation
Yes: No:
• Research & Writing
Yes: No:
• Marketing, Design & Curatorial Work
Yes: No:
• Event Planning & Production
Yes: No:
• Fundraising & Finances
Yes: No:
• Technology & Computer IT
Yes: No:
• Building & General Maintenance
Yes: No:
Please provide examples of these experiences:
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