Board of Directors Candidate Application

MISSION STATEMENT: Provide inpatient medical care for drug-exposed newborns, non-judgmental support for mothers, and education services to improve family outcomes.

Demographic Information

Preferred Method of Contact(Required)
Please list any Facebook, Instagram, Twitter/X and LinkedIn accounts

Employment Information

Education

Involvement

Please list boards and committees that you currently serve on and/or have served on in the past. This may include Business, Civic, Community, Fraternal, Political, Professional, Recreational, Religious and/or Social. Please include the organization, your role/title, and dates of service.
Optional: Have you received any awards or honors that you’d like Brigid’s Path to know about?
Skills, Experience and Interests(Required)
Please select all that apply