Board Consultant Interest Form

Name *

First

Last

Address *

Address Line 1

City

State

Phone *

Email

Preferred First Name

Spouse Name

First

Last

Briefly identify your work career, i.e. company, position, working or retired, etc.

Are you a member of Community Water Company of Green Valley? *

Yes
No

Are you a legal resident of Arizona? *

Yes
No

Are you a legal resident of the U.S.? *

Yes
No

Are you currently employed? *

Yes
No

If employed, may we contact your employer? (List in references below)

Yes
No

Have you been convicted of any felony? *

Yes
No

Have you been convicted of any crime? *

Yes
No

May we contact references? *

Yes
No

Please identify any other organizations that you support through volunteer activities. *

To assist us in utilizing your capabilities in supporting Community Water Company of Green Valley, please provide a summary of your education, background, and skills in areas such as leadership, mentoring, communications, and problem solving. *

References

Include current employer, if any.

Name *

First

Last

Phone *

Years Known *

Reference Type *

Business
Personal

Name *

First

Last

Phone *

Years Known *

Reference Type *

Business
Personal

Name

First

Last

Phone

Years Known

Reference Type

Business
Personal

I certify that the answers given herein are true and complete to the best of my knowledge; I authorize investigation of all statements presented in this form; I understand that this form shall be valid for six months, acceptance of my volunteer status is not an employment relationship with Community Water Company of Green Valley, and any false or misleading information presented in my form or interview(s) may result in separation with Community Water Company of Green Valley. *

I Agree

Completion of this form does not constitute acceptance of your request to volunteer for Community Water Company of Green Valley and the answers provided to questions on this form are for informational purposes only.

Board Consultant Interest Form

References

Project RENEWS

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