Snyder County Libraries Inc.
1 North High St.
Selinsgrove, PA 17870

APPLICATION FOR APPOINTMENT TO THE BOARD OF DIRECTORS


NAME:  __________________________________   HOME PHONE: _____________________
EMAIL ADDRESS: ___________________________ CELL PHONE: _______________________
ADDRESS:____________________________________________________________________
____________________________________________________________________________
City                County          State                   Zip

ARE YOU EMPLOYED?_____________________  RETIRED?_____________
BUSINESS ADDRESS___________________________________________________________
BUS. PHONE:_________________________  BUS. EMAIL:_____________________________

YOUR BACKGROUND:   What education or skills could you bring to the Board?
__Accounting ___Management ___Public Relations
__Investments ___Marketing ___Fundraising
__Office Skills ___Professional Skills ___Knowledge of Library Services
__Social Skills ___Education ___Affiliations
Others:  (Please explain)__________________________________________________________
______________________________________________________________________________

Charitable or community activities in which you have been involved:______________________ ______________________________________________________________________________

YOUR AVAILABILITY TO SERVE:
Can you attend Board meetings held the 4th Tues. of the month? ___Yes ___No ____Most times
Can you attend other planned meetings and functions? _____Yes  _____No

REFERENCES:  Please list three people who know you well, and their contact information:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

PLEASE INDICATE WHY YOU ARE INTERESTED IN JOINING THE BOARD:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Please return this application to Pam Ross, Executive Director, Snyder County Libraries, Inc.  
1 North High St. Selinsgrove, PA  17870.  
For further information, contact Pam at 374-3271 or scldir@ptd.net