Name:
Date:
Preferred Phone:
Alternate Phone:
Email Address:
Mailing Address:
How long have you lived in HAVEN's catchment area (Rockingham & Strafford counties)?
What is you occupation and place of employment: (if applicable)
How did you hear about HAVEN?
Please describe any previous nonprofit experience or relevant community experience that you may have:

HAVEN’s mission is to prevent sexual assault, domestic violence and stalking and to provide support and empower women, men, youth and families to heal from abuse and rebuild their lives. The Board of Directors supports this mission through oversight and management of the legal, financial and strategic planning needs of HAVEN. Some of the activities HAVEN Board Members commonly participate in include networking, relationship building, community engagement, fundraising and legal leadership.

Please summarize your interest in our organization:
Please tell us how you would be an asset to the Board of Directors and HAVEN:
Three References (Include name, title, relationship/affiliation and all contact information):
1:
2:
3:


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