North Houston FCA - Board Member Referral Form

Prospective Board Member Referral Form

Please complete this form so we can follow up with you about the individual you recommend as a prospective board member. Provide us with as much relevant information as you have about each candidate. Please return this sheet to the chair of the Governance Committee.

Board member completing the form?

Your First Name

Last Name

Date Input

Phone Number

Email

What is the best time to reach you?

Prospective Board Member Referral Form

First Name (Prospective Board member)

Last Name

Organization

Gender

Male

Female

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Email

Leadership Competencies:

Functional Expertise

Additional Information:

Please describe the reasons you believe this person would be a good fit to the FCA board?

Current board members to meet, cultivate and recruit prospective board member?

Does this person demonstrate a strong faith in God?

Yes

No

Professional Skills

Other Board experience:

Additional / Other information:

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