Board Member Application

FOUNDATION ON AGING FOR LARIMER COUNTY
Application for Board Membership

The FOA board meets the  second Tuesday of each month from 10:00 a.m - noon at the Office on Aging, 2601 Midpoint Drive, suite 112, in Fort Collins

Date: ___________________________
Name: _________________________________________________________
Address:  _______________________________________________________
Phone:  (home)________________________  (work)______________________
Email: ________________________________
Occupation: (If retired, indicate your former occupation)_________________
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Volunteer experience:__________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Why are you interested in serving on the FOA board? ____________________
_______________________________________________________________________
_______________________________________________________________________
What needs of seniors do you feel are not adequately met locally? _______
_______________________________________________________________________
_______________________________________________________________________
Your vision for a better quality of life for Seniors in Larimer County: _____
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

Thank you for your time and interest.  For more information, contact Bonnie Shetler at 970-224-5467 or Louise Quijano at 970-491-7448
Please return your application to FOA, P.O. Box 288, Fort Collins, CO 80522