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CCIDC Board Member Application
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CCIDC Board Member Application
CCIDC Board Member Application
CCIDC, Inc.
2025-01-27T08:41:10-08:00
CCIDC Board Member Application
CCIDC Board Member Application
Submit this form as well as your resume and a brief biography to apply to become a CCIDC Board Member. Qualified applicants will be required to attend a Board Orientation Webinar before the Selection Committee makes its final determination.
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Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Email
*
Phone
*
Website / URL
Address
*
Address Line 1
Address Line 2
City
--- Select state ---
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Which Board Position Are You Applying For
Why would you like to be considered to be a CCIDC Board Member
*
Board be to
Please list any applicable skills you have that would be an asset to this position
*
Upload your resume
*
Click or drag a file to this area to upload.
Upload a brief bio
*
Click or drag a file to this area to upload.
This information will be used for Board Member Bios on the CCIDC website
Professional Organization/Club/Group Affiliation/Membership
*
Please list any Professional Organization/Club/Group you are affiliated with or a member of as well as your level of involvement (If None, type "None"). Please Provide: Organization Name | Affiliation/Membership Level | Involvement status
Signature
*
Clear Signature
I declare under penalty of perjury under the laws of the State of California that the foregoing information is true, complete, and correct. False or incomplete information will result in automatic disqualification.
Date
Date Application Signed/Submitted to CCIDC
Submit Application
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