Application for Board of Directors

Please fill out the application below, and we will reach out to you for an introductory conversation.

First Name ^*

Last Name ^*

Address 1 ^*

Address 2

City ^*

State ^*

ZIP Code ^*

Phone Number

Email Address ^*

How did you hear about Jane's Room? ^*

Why are you interested in serving as a board member? ^*

Do you have prior experience serving on the board of directors of a nonprofit organization? If so, please describe. ^*

Do you expect to make a yearly personal financial contribution to Jane's Room?

Yes, I do plan to contribute.

No, I do not plan to contribute.

Are there additional contributions you hope to provide the organization? (i.e., corporate / foundation / media relationships). If so please describe. ^*

Please share any other information you feel is important. ^*

Upload your resume or bio (file upload: accepted file types include .doc, .docx, .pdf, limit 3 MB)

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Submit Application

Board Member Application