JBD Application Form – Carroll White REMC

Personal Information

Name*

Address*

Street Address Address Line 2 City State ZIP Code

Home Phone

Cell Phone*

Email*

Age as of September 1st

Guardian's Name*

Guardian's Phone/Cell*

Education

Name of Your School*

Year*

Junior
Senior

Graduation Year*

GPA*

What are your college/career goals?*

Are you able to provide your own transportation if necessary?*

Yes
No

Extra-Curricular Activities and Community Service Experience*

Why are you interested in serving on CW REMC’s Junior Board of Directors?*

Anything else you would like to tell us that will help with our decision?*

File Upload*

Drop files here or

Accepted file types: doc, docx, rtf, pdf, gif, png, jpg, jpeg, Max. file size: 120 MB.

Please attach two letters of reference. Letters should be from an adult that is not a parent or legal guardian attesting to your character. Teachers, coaches, church members, employers, volunteer groups are all acceptable references.

Commitment*

Yes

I have read the requirements for participation and am willing to commit fully to the Junior Board of Directors by attending the mandatory meetings and participating in projects and events. I verify the information provided is correct knowing if false information is given the privilege of serving on the Junior Board of Directors may be revoked. I also agree to sign this document electronically.

Full Name (Electronic Signature)*

(800) 844-7161

Personal Information

Education

(800) 844-7161