Referred By*Referred by Email* Name of Board Prospect* First Last Board Prospect's EmployerBoard Prospect's Job TitleBoard Prospect's PhoneBoard Prospect's Email* Is this prospect aware of this recommendation to the ASCC board?* Yes No Why would this individual make a good Board member?*Resources (check all that apply) Capacity to give Access to funders/donors Areas of Relevant Expertise* Accounting/Finance Behavioral Health Community Relations Education Entrepreneurship Event/Project Management Fundraising Health Care Human Resources/Personnel Management Law Marketing/Communications Grant writing/Assessment Not for Profit Experience Policy Development Research/Evaluation Strategic Planning Technology Volunteer Coordination/Management Other area of Relevant ExpertiseCommunity connections (check all that apply)* Philanthropy Corporate/Local business leaders Professional background* For-profit Government Non-profit Self-employed Other affiliationsOther Board serviceOther pertinent information
