Board Member Application Thank you for your interest in becoming a Board Member for the Madison Area Chamber of Commerce. Please review the 'Board Member Duties' document before submitting your application Name Block - Simple First Name * Last Name * Address Block - US Address Line 1 * Address Line 2 City * State * Select option... Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming DC Zip/Postal Code * Company/Organization * Position * Email * Why do you wish to serve on the Board of Directors? Briefly list any goals or objectives you have for your term on the Board. List the Chamber activities in which you have been involved as a participant or sponsor. List other community involvement.