Please provide the following contact information:

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

1. What interested you in becoming a TCPC Board member?

2. What experience have you had with people living with HIV and how did those experiences effect you and your perception of people HIV infected and affected?

3. What experiences have you had with TCPC’s affiliated groups or activities?

4. What if any, Board or other volunteer experience have you had? Please describe.

5. Please describe any fundraising you have done in the past. This could be anything from organizing or helping out at a variety of fundraising events, obtaining donations from individuals, corporations, foundations, or other groups, proposal writing, or having access to any of the above via your own personal contacts.

6. What skills and resources would you be able to bring to TCPCs Board?

7. What kind of time and energy are you willing to commit to TCPCs Board?

8. Please list at least 3 References: