THE MIAMI COALITION FOR THE HOMELESS, INC.
Board of Directors Board Member Application

Name:                  
   
                   
Business Address:                                 Home Address:      
     
                   
Date of Birth:                                          Race (optional):      
     
                   
Business Number:
 
 
Home Number:
 
 
Fax Number:
 
 
Cell Number:  
 
 
E-Mail:  
           
                   
Please explain your interest in becoming a Board Member.        
   
                   
                   
                   
   
                   
How did you hear about the Coalition?            
   
                   
                   
                   
   
                   
Which of the Coalition's three main areas of concentration interest you the most?  
   
                   
                   
                   
   
                   
Please list the skills/talents you will bring to the Board.        
   
                   
                   
                   
   
                   
Have you ever been convicted of a felony involving fraud, breach of fiduciary duty, or any type of financial misfeasance, within the past 10 years?   Yes    No
 
       
Please note that MCH takes these types of matters very seriously. If you have a conviction and would like to move forward in the application process, please provide an explanation in the space provided:
 

 
    
                    
                    
                    
    
                   

PLEASE ATTACH A CURRENT RESUME TO THIS APPLICATION DETAILING YOUR EMPLOYMENT AND VOLUNTEER EXPERIENCE


                 
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