TEXAS LAKES TRAIL REGIONAL PROGRAM

Board Member Application

Name:

Last First M.I.

Name you prefer to go by:

Address: City: Zip

Home Phone: ( ) Home Fax: ( )

Home e-mail:

Employer: Job Title:

Work address: City: Zip

Work Phone: ( ) Work Fax: ( )

Work e-mail:

Do you prefer to receive correspondence at home or work?

Please explain past experience in historic preservation and/or tourism development (use additional page, if necessary)

Describe why you are interested in serving on the Texas Lakes Trail Regional Board

What skills or attributes do you possess that would add value to the Texas Lakes Trail Regional Board?

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List two references who can speak to your attributes as a potential member of the Texas Lakes Trail Regional Board:

Name Address Phone

I understand that if nominated for and subsequently elected to the board that I am obligated to regularly attend meetings and be an active participant in the affairs of the Texas Lakes Trail Regional Program.

Signature Date

Please send this form to: Jill Campbell Jordan

Regional Coordinator

Texas Lakes Trail Region

116 W. Bridge St

Granbury, TX 76048

Phone: (817) 573-1114

Fax: (817) 573-8291

Email: