focus board of directors

Prospect Data Collection

Name(Required)
Preferred Name
Employment(Required)
May include your present position, recent past positions, education, volunteer work, recognitions and professional organizations (no resumes please!) While we do reserve the right to edit, we ask that you write your own bio so that the facts you consider most important are included. Personal info regarding marital status, children and hobbies is best kept to one sentence.
Max. file size: 20 MB.
This should be a high-resolution image; preferably a head and shoulders shot.
Home Address(Required)
Work Address(Required)
Preferred Mailing Address(Required)
Phone Type(Required)
Areas of Expertise(Required)
Check all that apply
MM slash DD slash YYYY
Gender(Required)
Check all that apply
Which categories describe you?(Required)
Select all that apply.