SomeDogPark, Inc. Board of Directors

SomeDogPark, Inc. will accept applications for Board of Directors positions on a continual basis, even if no vacancy exists. All applications will be read and processed in the order they are received. You may download an application by clicking here or by printing this page out, filling out the information below, and sending by mail to SomeDogPark, Inc., PO Box 53, Somerset, MA 02726.

Board of Directors Application

Name:___________________________________________________
Home Phone:_____________________________________________
Address:________________________________________________
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Cell Phone:____________________________________________
Other Phone:___________________________________________
E-Mail:________________________________________________

Relevant Experience and/or Employment, including any special skills or
training (attach resume):
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Why are you interested in SomeDogPark, Inc.?
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Area(s) of expertise/contribution(s) you feel you can make:

• ____ Fundraising development
• ____ Bookkeeping/financial skills
• ____ Present program to groups/organizations
• ____ Review/reply to correspondence
• ____ Initiate participation in community
• ____ Town politics experience
• ____ Grant search/applications
• ____ Dog/animal experience

Other information you feel may be helpful in the processing of your application:
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Have you ever been convicted of a crime? _____ Yes _____ No

If yes, please explain nature of offense and date of conviction:
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Have you used marijuana during the last 3 years or more than 15 times? _____ Yes _____ No

Have you used any illegal drug(s) other than marijuana more than 5 times or during the last 10 years? _____ Yes _____ No

By signing my name in the space below, I acknowledge that the information provided in this application is correct to the best of my knowledge, and I understand that all information provided by me on this application will be kept strictly confidential and will not be disclosed to any outside party under any circumstance.


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Signature                                                       Date


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For Board Use

___ Nominee has been contacted.
       Date _______________

___ Nominee’s application/resume reviewed by the Board.
       Date _______________

___ Nominee interviewed by the Board.
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Action taken by Board:

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