Menomonie Area Chamber & Visitor Center Committee Application

Committee of Interest

Advocacy Committee Ambassador Workforce & Education Committee Young Professionals Steering Committee Event-Specific Task Force (Short Term)

First Name *

Last Name *

Name I prefer to be called by: *

Home Address

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

Business / Organization Name: *

Position Title: *

Applicant Email *

Applicant Phone Number *

Business / Organization Address:

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

How long have you lived/worked in the Menomonie area? *

Are you applying as a representative of: (check one) *

A business An individual A club / organization

Describe how you contribute to the success of your business / organization. *

Why are you interested in serving on a committee with the Menomonie Area Chamber & Visitor Center? *

Describe how you feel the Chamber benefits the Menomonie area. *

Has the Applicant previously served on a Menomonie Area Chamber & Visitor Center Committee? *

Yes No

Applicant was an active participant of the following committee(s) prior to this application: *

Board of Directors Ambassador Workforce & Education Young Professionals Event Planning Committee None of the Above

Please select any / all committees previously served

Application is submitted by: *

Nomination by Supervisor Applicant

PERSONAL COMMITMENT *

YES NO

Committees require participation in one meeting each month as well as additional events and activities specific to the committee. Do you agree to be an active participant of the committee you are applying for?

What programs and events are you most interested in being involved in? *

BUSINESS / ORGANIZATION

Applicants for each committee must have the commitment and support of their sponsoring business or organization. The signature of the head of the sponsoring organization is necessary as an indication of support for the nominee’s participation in the program and commitment of the sponsoring organization to allow participation when called upon.

Name and Job Title of Sponsor: *

Electronic Signature of Applicant: *

Menomonie Area Chamber & Visitor Center

Menomonie Area Chamber & Visitor Center Committee Application

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