Nominee Submission

**Interfaith Prison Ministry for Women (becoming ARISE Collective)
Board of Directors Nominee Form

**Nominees, please fill out this form.**

If you are a Nominator, please visit IPMforWomen.org/Nominator for that form.

For your convenience, both Nominee and Nominator may download and fill out the fillable version of this form and email it to cherisse.kendrick@IPMforWomen.org.

Nominee:

* Indicates required field

Name *

First

Last

Mailing Address *

Line 1

Line 2

City

State

Zip Code

Country

Firm/Company: *

Title: *

Check one: *

Active Retired

Mobile Phone: *

Home Phone: *

Work Phone: *

Email: *

Current membership on other non-profit/charitable boards (please include title if an officer): *

Civic/community experience (including political or professional organizations, faith communities, etc.): *

Past experience with PPM/IPMW (volunteer, JobStart, etc.): *

What interests you about serving on IPMW's board? *

Submit