(716) 753-4123 casaofchautauqua@roadrunner.com

Board Application Form

This form may be downloaded (Microsoft Word or PDF), printed and mailed, or sent to us by email as an attachment. Or fill out the form below, and either print and mail it or submit it online. See also: Board Profile Form.

Online Application Form

Contact Information

Name

Email Address

Mailing Address

Phone Numbers
(h) (w) (c)

Education

School 1 and Degree/Area of Concentration

School 2 and Degree/Area of Concentration

School 3 and Degree/Area of Concentration

Employment

Employer 1

Position and Duties

Employer 2

Position and Duties

Experience

How did you hear of the CASA program?

What are your reasons for wanting to be a member of the CASA board of directors and/or standing committees?

What life, work or volunteer experiences have you had that would benefit you as a CASA board member and/or committee member?

What experience do you have relating to fundraising events and/or resource development for a not-for-profit agency?

How long have you lived in the area?

Availability and Commitment

Daytime Availability for Board/Committee Meetings

Evening Availablity

Weekend Availability

Exceptions

How long of a commitment are you willing to be a CASA board member and/or committee member?

Comments

Please contact our office if no response is received in seven days.