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| Name | |
| Address | |
| Address (cont.) | |
| City | |
| State | |
| Zip Code | |
| Home Phone | |
| Work Phone | |
| FAX | |
| Church |
I am interested in the following areas:
| Fundraising | Family Selection | Finance |
| Publicity | Construction | Family Nurture |
| Site Selection/Development | Church Relations | Volunteer Coordination |
| Board Membership |
I have special skills in:
| Finance/Accounting | Bookkeeping | Secretarial/Clerical/Computer |
| Legal | Public Speaking | Social Service |
| Construction | Other (Please Specify) |
List other skills or interests:
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