Advisory Board Membership Application

Please describe why you intend to join the Advisory Board?*

How can IMI benefit from your Board membership?*

Please list other Board memberships?*

Please write your professional resume summary in 100-150 words (this may be edited and posted on our website if you are selected to serve on the Advisory Board*

Have you ever been found guilty of fraud or ethics violations*?

NoYes

If yes, please explain:

Attestation

I hereby attest that the following statements are true:
a. If elected, I agree to abide by and perform all Advisor duties listed herein.
b. I have no financial interests that would present a conflict of interest in serving on the Board. If such conflict should arise, I agree to excuse myself from any such discussion, resign from Board, and leave if requested by the Board.
c. I agree to uphold the mission, purpose, and public presence of IMI and to support the organization and never take any action that may harm IMI.
d. I agree to help with the growth and sustainability of the organization.
e. I have no criminal history and have never been investigated for ethics violations.
f. I will not disclose any confidential information that I may obtain as part my Advisor duties to anyone.
g. I fully understand the role, requirements, and the information in this application. I hereby apply for the Advisory Board Member role. I understand that my application may be rejected and my membership can be revoked at any time without cause.