Prospective LFCC Educational Foundation Board Member Application Form

Items marked with an asterisk (*) are required.

Personal Information:

Prefix: Mr. / Mrs. / Ms. / Dr. / Other
Name:*
Nickname:
Suffix: Jr. / Sr. / III / IV/ Other
Birthday (month & day):
Spouse's Name:
Spouse's Nickname:
Spouse's Birthday (month & day):

Home:

Address:*

City:*

State:* Zip:*

Telephone:* Fax: E-mail:*

Business:

Business Name: Occupation: Address:

City:

State: Zip:

Telephone: Fax: E-mail:

Preferred Mailing Address:

Education:

Schools and/or Colleges Attended and Degrees Awarded:

Civic Involvement and Personal Interests:

Volunteer Organizations:
Interests and Hobbies:

Brief Questions:

Why are you interested in serving on the LFCC Educational Foundation Board?
What kinds of skills or expertise can you offer the LFCC Educational Foundation Inc.?
In what ways might the LFCC Educational Foundation Inc. benefit from your participation?
Please describe any current relationships or affiliations that might be perceived as a conflict of interest with LFCC.

Educational Foundation Inc.

About the Foundation

Prospective LFCC Educational Foundation Board Member Application Form