POAMN Workgroup Application

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Date*

Name*

First Last

Title

Mr.
Ms.
Mrs.
Rev.
Dr.
Rev. Dr.

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Phone

Church / organization

Role / title in that church / organization

Workgroup position(s) that interests you*

Please select one or more

Connectivity Workgroup
Education, Resources, and Training Workgroup
Partnerships Workgroup
Open to any

How long have you been involved with POAMN?

Brief bio*

Tell us about your experience in the Presbyterian Church and other organizations.

Skills or experience that would benefit POAMN*

Background in older adult ministry*

Certification

By submitting this application, I affirm that all information provided is true and accurate to the best of my knowledge. I understand that completing this application does not guarantee a position on the organization's board. Please type your name in the space below.

Board Workgroup Application