Broadband Leader Application

First Name *

Last Name *

Email Address *

Phone Number *

Address *

City *

State *

Zip Code *

How did you hear about us? *

How did you hear about us?

Are you a current dues-paying member of Broads? *

Yes

No, but I have been in the past

No, I've never paid dues

How many years have you been a member?

Are you a member of a local Broadband chapter? *

Yes

How long have you been involved with your local Broadband?

What attracted you to Great Old Broads for Wilderness? *

Potential Broadband Location – What would be the general geographic reach of your group? *

If you are planning to co-lead an existing broadband, let us know which one!

Why are you interested in being a Broadband Leader? *

Are there any specific wilderness/public lands issues you are most interested in working on that impact your region/state? *

What are other conservation organizations in your area that you are already affiliated with or have worked with in the past? *

What strengths and experiences will you bring to the role of Broadband Leader? *

Are there time constraints or any other considerations that could effect your ability to make a two-year commitment as a Broadband Leader.

Tell us briefly about your past/current leadership experience.

Electronic communication is an important tool for Broads. Describe your comfort/skill level using computers, especially for e-mail communication. *

Any additional information you’d like to share with us?

Please provide two references and their phone numbers we can contact to discuss your conservation and leadership experiences. *

Thank you for taking the time to fill out our leadership application!

We look forward to connecting with you soon. Please contact us in the meantime with any questions or concerns.

reCAPTCHA

Contact Us