Board of Directors Application

I certify, that the statements made on this application, on any resume, and attachments hereto, or other supplementary materials provided by me, are full and complete statements of the facts. I understand that false, misleading or omitted information will result in refusal of membership to the Board of Directors or termination in cases where erroneous information is discovered after membership has begun. I understand that if I am offered membership to the Board of Directors and accept, this application form becomes part of the terms and conditions of membership.