Delegate Application

(Please Print)

Contact Information

Name

Title

Business Name

Business Address

City ST ZIP Code

Work Phone

Other Phone

Fax

E-Mail Address

Availability
During which hours are you available for volunteer assignments?
Weekday mornings	Weekend mornings
Weekday afternoons	Weekend afternoons
Weekday evenings	Weekend evenings

Interests
Tell us in which areas you are interested in volunteering
	Administration
	Events
	Field work
	Fundraising
	Deliveries
	Phone bank
	Newsletter production
	Volunteer coordination
	___ Other
Recruitment
List the 3 names of people in your company you think would be interested in the delegates program.

Special Skills or Qualifications

Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.

Person to Notify in Case of Emergency
Name
Street Address
City ST ZIP Code
Home Phone	Other phone
Work Phone	Other phone
E-Mail Address

Delegate Commitment

Purpose: To maintain membership strength in the Chatsworth-Murray County Chamber of Commerce

Responsibilities:

1. Attend 50% of all Ribbon Cuttings per quarter.

2. Attend 50% of all Delegate meetings.

3. Call on five or more members per month.

4. Adopt a member for any Chamber event

5. Participate in visitation of existing members.

6. Obtain feedback from the members about Chamber activities.

7. To promote goodwill for the Chamber in the community.

8. Have fun and promote Murray County and the Chatsworth-Murray County Chamber of Commerce

By submitting this application, I agree to the above responsibilities. I understand that if I am accepted as a volunteer sever lack of participation may result in my dismissal from the delegates program.

Name (printed)

Signature

Date

Thank you for completing this application form and for your interest in volunteering with us.