Apply to Join the Board -

Name *

First

Last

As per agency policies, members must be vaccinated (including COVID-19 vaccines). By submitting this application, you are stating that you are vaccinated and that you are willing to provide evidence of vaccination or medical exemption if requested. Do you understand?

Yes
No (Do not submit an application)

Email *

Phone Number *

Address

Current Employer/Role *

Are you a previous recipient of our services? *

Yes
No
I know someone who is/was

I can meet once a month on Wednesdays at noon *

Yes
No

I bring the following to the board: *

Explain to us what you can bring to our board *

What about Restorative Justice & our programs inspires you? *

As a member of our board, what do you hope to accomplish? *