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BOARD OF DIRECTORS

Baton Rouge AIDS Society is looking for dedicated members to serve on the Board of Directors.
To apply, please call 225-923-AIDS (2437)
or fill out the form below.

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To be considered for a Board of Directors position at Baton Rouge AIDS Society,complete the form below.

The fields marked with (*) are required fields.

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Today's Date
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First Name
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Last Name
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Sex
Male
Female
 
Date of Birth
 
Age
 
Race
African American
Asian
Caucasian
Hispanic
Native American
Other

*
Address
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*
City
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*
State
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*
Zip Code
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Country

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Telephone Number
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Cell Number
 
Email Address
 
Employer
 
Employment Title
 
Employer Address
 
City
 
State
 
Zip Code
 
Employer Phone
 
Employer Fax
 
At which address would you like to receive information?
 
Church Affilliation
 
List all Educational/Professional trainings(Degrees, Certificates,etc.)
 
Please list other community activities and involvement:
 
How can your experience contribute to the mission of Baton Rouge AIDS Society?
 
What do you hope to see accomplished as you serve your term on the Boad of Directors?
 
Please explain any potential or actual conflict of interest which might affect your participation:

*
BRASS Board members must be active on at least one committee. If elected to the BRASS Board of Directors, which of the following committtes are you most interested in serving:
Bylaws/Policies and Procedures
Finance
Nominating
Personnel
Public Relations
Strategic Planning
 
Please select any of the following which you have special knowledge, expertise, or influence:
Business/Financial
Consumer/Family Issues
Ethnic/Minority Groups
Grant Writing/Fund Development
Health Care Providers
HIV/AIDS Services
Human Resources/Personnel
Legal Affairs/Government
Marketing
Media/Communications
Non-Profits
Religious Community
Service Development
Social Services
Women, Infant, Children Issues
Other
 
If you would like to provide additional information or comment, please feel free to add them within this area: