Advisory Committee Application Contact InformationYour Name(Required) First Last Your Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Company/Organization InformationOccupation(Required) Phone Number(Required)Your Company/Organization Email Address(Required) Email Address Confirm Email Address Company/Organization Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Tell Us More About YouRelevant Experience and/or Employment:(Required)Why are you interested in serving on the KidsFirst Advisory Committee?(Required)I can help KidsFirst in the following ways:(Required)Please list your current memberships in other organizations (professional, social, etc.):(Required)Other volunteer commitments:(Required)Your Expertise:(Required) Fundraising - Capital Campaign Fundraising - Donor Solicitation Fundraising - Special Events Human Resources Legislation Physical/Plant Facilities Policy Presiding Officer Relevant Program Expertise Strategic Planning Treasurer/Finance Public Relations Marketing Media Please check all that apply.Your Professional Connections:(Required) Business/Corporate Child Welfare Clergy/Religious Education Finance Government Health Care Law Enforcement Legal Philanthropy Technology/Web Design Graphic Design Media Other Please check all that apply. Please Specify Other Professional Connections.
