Family Support Network Board Member Application

Make a difference in your community.
Apply to be a FSN™ Board Member.

Click to view board member responsibilities

APPLICATION FOR BOARD MEMBERSHIP

Thank you for your interest in serving on our board. Family Support Network™ of Southeastern NC Inc. believes that the greatest asset a child can have is a strong family. Our mission is to provide support, education, and caring connections to those who have a child with special health care needs or born prematurely. The Board meets the quarterly for two hours; an annual meeting is in the fourth quarter.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Applying as a

Professional

Parent

Number & Age of Children

Child's Special Need

Employment

Previous Employment

Please list other voluntary organizations on which you have served/are serving and what positions you have held.

Your special interests and skills in areas related to the mission of FSN, which you would like to utilize and would prove an asset to FSN.

Brief educational background or any other relevant information.

I am able to commit to attend 75% of Board Meetings and serve on one committee for one year during term of office.

Yes

By checking below, I certify that this information is correct to the best of my knowledge and acts as my digital signature.

Yes

Make a difference in your community. Apply to be a FSN™ Board Member.

APPLICATION FOR BOARD MEMBERSHIP

Family Support Network™of Southeastern NC

Make a difference in your community.
Apply to be a FSN™ Board Member.

Family Support Network™
of Southeastern NC