Board of Directors Candidate Application

Name

Address

Phone

Cell Phone

Date of Birth

Employer

Employer's Name

Employer's Address

Employer's Phone

Employer's Email

Your Title

Type of Business or Organization

Primary Service(s) and Area/Population Served

Preferred Method of Contact

Work

Residence

Please list boards and committees that you serve on or have served on (business, civic, community, fraternal, political, professional, recreational, religious, and/or social)

Organization

Role/Title

Dates of Service

Organization

Role/Title

Dates of Service

Organization

Role/Title

Dates of Service

Education/Training/Certificates

How do you feel the Domestic Violence Intervention Program would benefit from your involvement on the Board?

Please list any groups, organizations, or businesses that you could serve as a liaison to on behalf of the Domestic Violence Intervention Program

Please tell us why you are interested in working with DVIP

Please tell us anything else you'd like to share

References

Name

Phone

Address

Name

Phone

Address

The DVIP Board of Directors currently meets on the fourth Thursday of the month, 5:30-7:00.

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Domestic violence (also referred to as intimate partner violence (IPV), dating abuse, or relationship abuse) is a pattern of behaviors used by one partner to maintain power and control over another partner in an intimate relationship.

Board of Directors Candidate Application

Board of Directors Candidate Application

Employer

References

Have questions? Need help?
Give us a call 24/7/365

Free and confidential hotline

800.373.1043
800.228.1625

All services free and confidential

Board of Directors Candidate Application

Employer

References

Have questions? Need help? Give us a call 24/7/365

Free and confidential hotline

800.373.1043 800.228.1625

All services free and confidential

Have questions? Need help?
Give us a call 24/7/365

800.373.1043
800.228.1625