City of Dunn Police Athletic/Activities League

610 East Johnson St. / Post Office Box 1065 Dunn, N.C. 28335
Office 910-892-1873 / Fax 910-892-9962 www.dunnpal.org
FILLING PLAYGROUNDS, NOT PRISON’S

Advisory Board Application

Date: ________________

Name: _____________________________________________ Date of Birth: __________________

Address: _____________________________________________________ City: ________________

State: _____ Zip: ________ Home Phone#: ___________ Cell# _____________Work# ___________

Social Security Number: ____-_____-________ Sex: ________ Race: _________

Place of Employment: _______________________________________ City: ___________

Any prior Criminal Record? (circle one) YES / NO
If yes, please describe: _________________________________________________________________

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Your reason for applying for an Advisory Board Position? _____________________________________

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What can you bring to the board that will help PAL and the youth? ______________________________

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Do you have any prior fundraising experience? (circle one) YES / NO

If yes give location/organization and what type of experience you have: __________________________

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Give number of years you will be willing to serve on the board: ______ years.
Give what positions you are willing to accept on the board (president, VP, secretary, etc.)
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Please state any other experience and/or comments you may have: ______________________________

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Applicant signature: __________________________________ Date: ___________________________

Wittness: _________________________________________ Date: ____________________________

Board Use only: Approved / Rejected Date: ___________ Term exp. _____________
Board Positions and years since approval: ___________________________________________________
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Director Lt. R. W. Rowland
Advisory Board
Executive Director - Chief of Police B. P. Jones
President – Bryan Galbreath Vice President – Kareen Teasley Secretary – Millicent Massey