LPBG Board Application – Lincoln Park Business Group

Applicant Contact Details

Your Name *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal code *

Phone *

Email Address *

Business / Organization / Employer

Business / Organization Name

Your Title

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal code

Phone

Email Address

Type of Business / Organization

Primary service(s) and area/population served

Preferred Method of ContactWorkHome

Applicant Experience

Please fill out the fields below and/or upload your current resume.

Upload file

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Board and Committee ServicePlease list boards and committees that you serve on, or have served on (business, civic, community, fraternal, political, professional, recreational, religious, social, etc.)

Education / Training / Certificates

Awards / Honors

Other Information

Please fill out the fields below and/or upload your current resume.

How do you feel the LPBG would benefit from your involvement on the Board? *

Please list any groups, organizations or businesses that you could serve as a liaison to on behalf of LPBG.

Please tell us anything else you’d like to share.