OPX Family Advisory Board Application

OPX Family Advisory Board Application
Parent/Guardian's Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Northwood/HighpointJamestown MiddleSouthwest MiddleHairston MiddleJackson MiddlePeck ExpeditionaryStokesdale/SUMC
Name of Child 1*

First NameLast Name
KindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8
Name of Child 2

First NameLast Name
KindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8
Name of Child 3

First NameLast Name
KindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8
YesNo
MonthlyQuarterly (every 3 months)
In-personVirtualHybrid (some members in person & some virtual)
YesNo
List job title, name of employer, responsibilities etc.
What skills do you have? Please share. (i.e. communication, technology, mentoring, tutoring, fundraising, health & wellness etc.)
Are you involved in any activities, professional and/or religious organizations (memberships, committees, etc.)? Please share.
Is there anything that may keep you from participating (i.e. transportation, childcare, work schedule etc.)? Please share.
Any topics that you would like for us to discuss or activities you'd like for us to plan? Please share.
WeekdaysEveningsWeekendsFlexible
Should be Empty: