Board of Directors Application

PERSONAL INFORMATION

First Name *

Last Name *

Address *

City *

State *

Zip Code *

Are you a current GTMC Member? *

Yes

No

GTMC Membership Number

Are you related to any current GTMC employee or board member? *

Yes

No

Which Exchange are you applying for? *

EDUCATION

High School

College

Major

Advanced Degree(s)

Certification(s)

EMPLOYMENT

Current Employer

Supervisor

QUALIFICATIONS

Previous Boards/Groups

Explain why you want to be a GTMC Board Member

BUSINESS REFERENCES

Name

Contact Number

Name

Contact Number

Name

Contact Number

PERSONAL REFERENCES

Name

Contact Number

Name

Contact Number

Name

Contact Number

SIGNATURE

Signature *

Please type your full name to represent your digital signature.

Date