Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

CheckboxI’m Interested In (check all that apply): *

Serving on the Board of Directors

Volunteering at Events or Retreats

Offering Professional Expertise (e.g., legal, finance, wellness)

Assisting with Social Media or Marketing

Facilitating a Workshop or Healing Session

Other: __________________________

Are you able to attend bi-monthly board meetings (virtual)? *

Yes

No

Maybe

How many hours per month could you realistically contribute? *

1-5

6-10

11+