Applicant Name                                 ________________________________________

Applicant Credit Union Name            ________________________________________

Applicant Title                                    ________________________________________

My credit union experience is as follows: 

______________________________________________________________________________________________________________________

My Chapter and/or League experience is as follows: 

______________________________________________________________________________________________________________________

My areas of expertise or interest that will assist the board:

______________________________________________________________________________________________________________________

I would like to be on the Chapter Board because:

______________________________________________________________________________________________________________________

This is to certify that I am a member of an affiliated credit union of the League of Southeastern Credit Unions and am a credit union official or employee of an affiliated credit union; I understand that this position will require a commitment to actively participate in the planning and execution of chapter events during and after business hours; and it is my desire to officially file for Chapter Director of the Tallahassee Chapter of Credit Unions.

Applicant Signature:          __________________________________        Date: _______________

President/CEO Name:       ______________________________________________

President/CEO Signature:  ______________________________________________

President/CEO E-mail:       ______________________________________________

Applications should be returned no later than January 31 of each calendar year to be considered.  Elections are held at the Chapter Annual Meeting.  Open seats may be filled throughout the year by appointment.