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.