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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Name
Address
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
This information will be used for Board Member Bios on the CCIDC website
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
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 Application Signed/Submitted to CCIDC