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PROSPECTIVE BOARD MEMBERS APPLICATION
Your Name:
Address:
City, State, ZIP:
Home Phone:
Office Phone:
Cell Phone:
Email Address:
Previous Board Experience:
Previous Fund-Raising Experience:
Employment Experience:
Describe your knowledge of Fiscal Management: i.e., budgets, audits, etc:
What additional expertise do you offer:
Why do you wish to become a board member of Port Counseling Center, Inc.:
Please attach resume if available:
Port Counseling Center
225 Main Street
Port Washington, NY 11050
Phone: (516) 767-1133
Fax: (516) 767-3680
E-mail:
portcounseling@verizon.net
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