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c:\users\chamber-new\documents\membership\board application form.doc
Warwick Valley Chamber of Commerce P.O. Box 202
Warwick, NY 10990 www.warwickcc.org
MISSION STATEMENT
The WVCCs objective is to foster cooperative action in advancing the civic, commercial, industrial, professional, and common interests of the
organizations members in the Town of Warwick, Orange County, and surrounding areas.
CONTACT INFO Last Name______________________________________________
First Name______________________________________________
Company_______________________________________________
Address________________________________________________
Position________________________________________________
Type of Business_________________________________________
Day Phone______________________________________________
Fax____________________________________________________
Email__________________________________________________
EMPLOYMENTS (start with current & go in reverse chronological
order)
Employer________________________ City____________ ST____
Title_____________________ Responsibility____________________
Employer________________________ City____________ ST____ Title_____________________ Responsibility____________________
Employer________________________ City____________ ST____
c:\users\chamber-new\documents\membership\board application form.doc
Title_____________________ Responsibility____________________
Please list your Industry experience: ________________________________________________________
________________________________________________________
________________________________________________________
__________________________________________________________________________________________________________________________
______________________________________________
Please list your Skills & Talents:
_____________________________________________________________
_____________________________________________________________
__________________________________________________________________________________________________________________________
____________________________________
________________________________________________________
Please list any other organizations you currently belong to; along
with your Role and Position:
_____________________________________________________________
__________________________________________________________________________________________________________________________
_____________________________________________________________
____________________________________
________________________________________________________
Briefly outline your community service and volunteer activities:
_____________________________________________________________
__________________________________________________________________________________________________________________________
_____________________________________________________________
____________________________________
________________________________________________________
What has been you most rewarding volunteer experience, and why?
__________________________________________________________________________________________________________________________
_____________________________________________________________
c:\users\chamber-new\documents\membership\board application form.doc
_____________________________________________________________
____________________________________
________________________________________________________
The Five Simple Responsibilities of WVCC Directors:
1-Attend 60% of scheduled Board meetings. Come prepared to discuss the
items on the agenda.
2-Attend at least five (5) Chamber sponsored events.
3-Serve a three (3) year term.
4-Serve as an ambassador for the Chamber interpreting the mission of the
organization, while representing it to your constituencies and spheres of
influence.
5-Chair a committee and/or serve on a committee that interests you and will utilize your expertise or those of your business associates.
Applications are to be submitted to the WVCC Nomination Committee by the first of each month. You may mail to: WVCC Nomination Committee, PO
Box 202, Warwick, NY, 10990.
Signature_________________________________ Date__________
To apply, please send a written request on company letterhead to the Board of Directors Nomination
Committee for consideration. Please call 845-986-2720 or email: [email protected] with any questions.