Name

Date of Birth

Spouse

Date of Birth

Date of Anniversary

Mailing Address

Home Phone

Work Phone

Cell Phone

E-Mail

Fax 

I have read the information in this packet and I am in agreement with its content. As a member of the board, I will endeavor to use my God-given abilities to advance the vision of Go To Nations.

It is my desire to serve as a member of the board of directors of Go To Nations for a minimum of three years with the commitment to attend all regularly scheduled board meetings. I will, to the best of my ability, fulfill the duties and responsibilities of a board member.

 

Signature of nominee

Date