Children’s Grief Center of New Mexico
Application for Board of Directors Membership
Thank you for your interest in the Board of Directors of the Children’s Grief Center of
New Mexico, Inc. Please complete the following questionnaire so that we can make
the best use of your talents and expertise and offer you the most rewarding
experience as a member of the Board.
The mission of the Children’s Grief Center is to provide a safe and supportive
environment in which children, teens, and their families can share experiences and
feelings while grieving a death.
Business Affiliation ______________________________________________________
Mailing Address ________________________________________________________
Business Phone _________________________ Home Phone ____________________
Fax __________________________ E-mail __________________________________
Emergency contact person _______________________________________________
Please check the experience and skills you will contribute to the Board:
□ accounting/financial □ management □ public speaking
□ investment □ marketing/PR □ fundraising
□ special events □ community relations □ advocacy
□ strategic planning
□ other ______________________________________________________________
How did you learn of the Children’s Grief Center?
What is your experience as a member of other Board of Directors/Trustees?
Will you attend regular (alternating Sundays 3pm-5pm or Wednesdays 7pm – 9pm at
Sunset Mesa School 9-10 times per year?) Board meetings and special meetings?
□ yes □ no
How many hours a month can you serve our agency outside of regular board meetings?
______________________ Day?_______ Evening?________
How do you think you can help further the mission of The Children’s Grief Center?
Please provide 3 professional or volunteer experience references:
email: email@example.com fax: 298-6132 or
Mail Completed Application to:
Children’s Grief Center of New Mexico, Inc.
P.O. Box 20218
Albuquerque, NM 87154-0218
“Offering hope and healing to grieving families since 2001”
Revised Feb. 2009