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Personal Inventory & Skills Assessment (PISA)

2. Personal Characteristics
4. Name
6. Gender

   1. male
   2. female
7. Age Range

   1. 21-30
   2. 31-40
   3. 41-50
   4. 51-60
   5. 61-70
   6. over 70
9. Racial ethnic information (optional)
   -- Select One --American Indian or Alaskan NativeAsian or Pacific IslanderAsian IndianAsian OtherBlack, African American, NegroChineseCubanFilipinoGuamanian or ChamorroHispanic, Latino, Spanish originJapaneseKoreanMexican, Mexican American, ChicanoNative HawaiianPuerto RicanSamoan or other Pacific IslanderVietnameseWhite
11. Skills & Experience
13. Check all that apply. When appropriate, please give additional information below:

    1. Architect / engineer*
    2. Board experience elsewhere*
    3. Business owner
    4. Construction
    5. Community involvement
    6. Counselor / social worker
    7. Diversity / minority affairs
    8. Educator / child development
    9. Finance / budget*
    10. Historic preservation
    11. Human relations / personnel
    12. Homemaker
    13. Law
    14. Museum background
    15. Politics / government
    16. Public relations / marketing
    17. Religious leader
    18. Sales
    19. Strategic and long-range planning
    20. Other*
15. *Please explain further:
17. Educational Background
19. Schools attended:*
21. Major / concentration:*
23. Degrees attained:*
25. Community
27. Years in community:*
28. Native Napervillian?*
    -- Select One --NoYes
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field