*
Required
Full Name of Candidate
Home Address (Street, City, Zip)
Telephone (cell, home)
Email Address
Religious affiliation/denomination
Congregational affiliation, if any
Candidate's profession
Candidate's current job title and employer
Candidate's age group
19-34
35-49
50-64
65+
Commitment to Levine Academy:
Name(s) of any child/children of Candidate that are current enrolled as students at Levine Academy
Please describe any current or past work by Candidate with Levine Academy Board of Trustees, Parents Association, committees including, but not limited to, fundraising efforts
Please describe any other connections that Candidate has to Levine Academy (consider alumni, parents/grandparents of alumni, Jewish community activists/philanthropists, Jewish educators, skilled professionals)
Commitment to Jewish and general communities (consider volunteer, civic, professional and business activities) including experience on Boards for non-profit and/or educational organizations
Personal characteristics, specialized education and/or skills (e.g., Finances, HR, Legal, Technology, Marketing, Construction, etc.) and leadership abilities of Candidate
Why do you think that this person would be an asset to the Board?
Name and contact info (email/phone) of Recommending Person (if other than self)