Board Member Application

Mission Statement: Promoting the importance of the social emotional well-being of infants and young children and their families in Alaska by strengthening and supporting those that touch their lives

First Name *

Last Name *

Email *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone (with area code) *

Educational Background (Please include degrees and certifications.) *

Work and Volunteer-related Experience *

How do your interests/experiences reflect the AK-AIMH mission? *

How will your unique perspectives strengthen the Board? *

What experiences or skills do you have that are related to Board work? *

Board Member Commitment Willing to dedicate up to 10 hours/month Serve on a committee Become a member of AK-AIMH

Please check all boxes to confirm your commitment.