top of page
Home Page
CASA of Menominee/Marinette
admin@casaofmenomineemarinette.com
715-923-7250
915 14th Avenue, Menominee, MI 49858
Serving Menominee County, Michigan and Marinette County, Wisconsin
Volunteer Login
Board of Directors Application:
First name
*
Last name
*
Email
*
Phone
*
Address
*
Current Employer & Job Title
*
Have you served on other Board of Directors?
*
Yes
No
If yes, for what organization(s), for how long, and what was the reason for leaving?
Please list any skills you may have that would be of benefit to the Board of Directors?
*
Are you aware that a commitment to the Board of Directors entails meetings as well as active committee assignments?
*
Yes
No
Are you aware of any conflict of interest that exists between you and CASA of Menominee/Marinette's program?
*
Yes
No
If yes, please explain.
Have you ever been convicted of a felony?
*
Yes
No
If yes, please explain.
In 75 words or less, please provide a personal statement providing your interest in becoming a member of CASA of Menominee/Marinette's Board of Directors.
*
Do you authorize CASA of Menominee/Marinette to conduct a background check, conduct a criminal background check, and release the results of said check to the current CASA Board of Directors for review?
*
Yes
No
Social Security Number
*
Birthday
*
Month
Day
Year
Prior Names (ex: maiden name)
Previous address within the last 5 years
Signature
*
Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.
Date
*
Month
Day
Year
Submit
bottom of page
