Contact Information:

Name of Candidate:
Address:
City, State, Zip:
Email address:
Telephone:

Information Questions:

Are you a member of Westminster?      Yes       No      
Are you available to meet most Tuesdays,
8:45 - 9:45 a.m., September through March?		 Yes       No      
Are you computer literate (email, Microsoft Word)? Yes       No      
Have you ever attended Town Hall South lectures? Yes       No      

Experience:

Volunteer and/or work experience and interests:

Additional Information:

How do you believe you can contribute to the THS Board? (optional)