For which are you applying?
Board of Directors*
Advisory Committee

First Name:

Last Name:

Street Address:

Town:

Zip:

Tel:

Fax:

Email:

Service Branch:

Dates:
From To

Rank or Rate:

Type of Discharge:

Significant Honors:

Veterans Service Organization(s):

If Still Working
Name of Employer:

Type of Business:

Location:

Brief Job Description:

Retired:
Yes
No

Previous Profession or Occupation(s):

Please describe your special skills and interests and how you believe you can best contribute to the Veterans Housing Coalition of Maine:

Other Boards or Professional Affiliations:

Please Check Suggested Role(s):
Wants to learn more about VHCofME

Prospective Donor

Major Gift Prospect

Potential Volunteer

Potential Advisory Board Member

Potential Board Member

* Directors must be veterans