Form for Appointed Positions on ICF Board

Nominations to Board Appointments close on July 1st, 2017

Nominee’s given name:

Nominee’s family name:

Email:

Phone (including country & area codes):

Fax (including country & area codes):

Full contact address:

Nationality:

Date of birth:

Seeking Appointment to which Board Position(s):

Ambassador/Outreach (Appointed Position)

Communication (Appointed Position)

Congress Oversight (Appointed Position)

ICDC Oversight (Appointed Position)

Membership (Appointed Position)

Business Development (Appointed Position)

Program Services (Appointed Position)

Member at Large (Appointed Position)

Please provide a brief background statement of work history and current work situation (Max : 500 Character):

I agree to meet the obligations as outlined for the position/s indicated above : Yes No

Please attach a photo (head and shoulders) here (Min : 1000 x 1000)(Optional):

Delete image

required

FORM FOR APPOINTED POSITIONS ON ICF BOARD