Board Application | HeartLove Place

📍 We've moved! Come visit HeartLove Place inside the YWCA at 1915 N Dr. Martin Luther King Jr Drive Suite #250 🙌📍 We've moved! Come visit HeartLove Place inside the YWCA at 1915 N Dr. Martin Luther King Jr Drive Suite #250 🙌📍 We've moved! Come visit HeartLove Place inside the YWCA at 1915 N Dr. Martin Luther King Jr Drive Suite #250 🙌📍 We've moved! Come visit HeartLove Place inside the YWCA at 1915 N Dr. Martin Luther King Jr Drive Suite #250 🙌📍 We've moved! Come visit HeartLove Place inside the YWCA at 1915 N Dr. Martin Luther King Jr Drive Suite #250 🙌

Board of Directors Application

1915 N Dr. Martin Luther King Jr Drive Suite #250 | Milwaukee WI 53212 | (414) 372-1550

Personal Information

First Name

Middle Name

Last Name

Present Address

City

Zip Code

Home Phone

Business Phone

Questionnaire

Why are you interested in serving on the Board of HeartLove Place?

What is your vision or goal for serving on the Board of Directors?

Please share your current church affiliation and your relationship with Jesus Christ.

Areas of expertise/contribution you feel you could make to HeartLove Place

Other volunteer commitments

Additional Information / Qualifications

Work Experience

Job Title

Dates

Company Name

Company Address

City, State, Zip

Work Phone

Attach Resume (Optional)

Education

College

Degree

Year Earned

References

Please provide 3 references. One must be from your Pastor, other two from a non-relative.

Reference 1 (Pastor)

Name

Address, City, State, Zip

Phone (Home/Business)

Reference 2

Name

Address, City, State, Zip

Phone (Home/Business)

Reference 3

Name

Address, City, State, Zip

Phone (Home/Business)

CERTIFICATION AND RELEASE:

I certify that every statement made in this application for service with HeartLove Place, Inc. is true and complete to the best of my knowledge and beliefs. Each statement is made in good faith. I hereby request organizations and individuals having knowledge about me to provide HeartLove Place, Inc. with the service related information necessary to accurately evaluate my application. I also release the source of information from any liability or damage whatsoever which may be a result of providing the requested information.

Applicant's Signature (Type Full Name)

Date Signed