Application for membership in the WBAI Local Station Board Management Search Committee
1. Name and Contact information (including address, email, phone numbers)
NAME ________________________________________________ EMAIL ADDRESS __________________________________________
ADDRESS ________________________________________________ CITY _________________________ STATE ____ ZIP ________
HOME PHONE ____________________________________ WORK PHONE ___________________________________
2. Are you applying to be a listener representative on the committee or a staff representative? (circle one)
Listener Staff
3. Please provide a brief explanation of why you want to be a member of the committee.
4. Any other information that you think is relevant or that the committee should know. (If you think you may have a conflict of interest being on this committee or you have some special skills and/or background that make you suitable for this task, this is the place to tell us about it.)
E-Mail to [email protected], OR
Please print out mail forms and snail mail them so that we receive them by September 7, 2009, to:
WBAI Local Station Board
att: Mitchel Cohen, Chair
120 Wall Street, 10th floor
NYC 10005