Board of Directors Application

Name *

Email Address

Phone *

Street Address

City

State/Province

ZIP / Postal Code

Occupation

Employer

Experience *

Please list boards and/or committees that you serve on or have serve on with the dates of service (ex. New Legacy, Board Chair 4/1/20-4/1/21) Your answer

Education/Training/Certificates Your answer *

Any other skills, experience and interests not listed above

Briefly describe why you would like to join New Legacy's Board of Directors. *

What would you like to gain for yourself out of your participation on the Board, e.g. what types of experience, skills to develop, interests to cultivate for you, etc.? Your answer *

If you join the Board, you agree that you can provide at least 5 hours a month in attendance to Board and committee meetings, and that you do not have any conflict of interest in participate on the Board? *

New Legacy Reentry Corporation Board of Directors Application