Board of Directors Application

Name

First Name *

Last Name *

Company

Title *

Industry *

Email *

Phone Number *

Are you currently an Oregon Chamber member? *

Yes No, but will become a member by 12/31.

If yes, for how long?

Please share a short biography (100 words or less) *

Please share any prior board experience and/or leadership positions including dates

What are skill sets or talents you possess that would benefit a well rounded Board? *

Are you able to make the PERSONAL commitment listed above? *

Yes No I'd like to discuss this with a board member.

Are you able to make the BUSINESS commitments listed above? *

Yes No I'd like to discuss this with a board member.

Anything else you'd like to add?