Board Bio Submission

1
Broad pool member
YESNO
2
Source
Board Bio submission form
3
Name* This field is required.
First Name
Last Name
4
Email* This field is required.
example@example.com
5
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
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Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
Phone Number
Please enter a valid phone number.
7
Ethnicity
African American/Black
American Indian/Alaskan Native
East Asian
Latinx/Hispanic
Middle Eastern
Pacific Islander
South Asian
White/Caucasian
8
With which gender identity do you most identify?
Female
Male
Genderqueer or nonbinary
9
Do you identify as LGBTQIA?
YESNO
10
LinkedIn
11
Current Organization
12
Current Title
13
Referred By
14
Submit your board bio and headshot* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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15
Board Bio location
16
Which corporate boards do you currently sit on?
17
Which non-profit boards do you currently sit on?
18
What is your board type interest?
Public
Non-Profit
Private
Private Venture
Venture backed
International
Private Equity
Speciality Mutual Fund/REIT/ESOP
Government
19
What type of board have you sat on as a Director?
Public
Non-Profit
Private
Private Venture
Venture backed
International
Private Equity
Speciality Mutual Fund/REIT/ESOP
Government
20
Which are your industry interests?
Adverting and Marketing
Aging
Agriculture
Agritech
Alternative Energy
Artificial Intelligence
Automotive
B2B
B2C
Big Data
Biotech
Blockchain
Child Care
Civil Rights
Clean Energy
Climate change/Environmental justice/Conservation/Water
Cognitive Neuroscience
Commercial Banking
Commercial Insurance
Commercial Lending
Community and Social Services
Compliance
Construction/Architecture
Consulting
Consumer Energy
Consumer Internet
Consumer Products
Cosmetics
Criminal Law
Cross-border/Government relations
Cybersecurity
DEI
E-Commerce
Economic Security
Education
Education/Literacy
Efficiency
Elderly Care
Electric Vehicle
Enterprise Apps
Environmental and Sustainability
ESG
FashTech
FemTech
Financial Planning
Financial Services
FinTech
Food and Beverage
Food Security
Games/Gaming
Gender/Sexuality
Global Leadership
Green Building
Green Consumer Goods
Green Financing
GreenTech
Healthcare/Public Health/Womens Health and Reproductive Justice
Human rights/Social justice
Internet Of Things
Journalism
Language Learning
Law/Policy/Advocacy/Government/Politics
Machine Learning
Manufacturing
Medical
Medical Device
Microfinance
Molecular Biology
Nanotechnology
Natural Beauty
Nutrition
Payments
Pets
Pharmaceuticals
Product Design
Product Positioning
Publishing
Racial Equity/Diversity and Inclusion
Real Estate
Renewable Energy
Retail
Robotics
Sales
Science/Biology and Chemistry
Smart Power
Solar and Wind Energy
Telecommunications
Transportation
Violence prevention/anti-human trafficking
Women and girls leadership and empowerment
21
Which are your industry experience?
Adverting and Marketing
Aging
Agriculture
Agritech
Alternative Energy
Artificial Intelligence
Automotive
B2B
B2C
Big Data
Biotech
Blockchain
Child Care
Civil Rights
Clean Energy
Climate change/Environmental justice/Conservation/Water
Cognitive Neuroscience
Commercial Banking
Commercial Insurance
Commercial Lending
Community and Social Services
Compliance
Construction/Architecture
Consulting
Consumer Energy
Consumer Internet
Consumer Products
Cosmetics
Criminal Law
Cross-border/Government relations
Cybersecurity
DEI
E-Commerce
Economic Security
Education
Education/Literacy
Efficiency
Elderly Care
Electric Vehicle
Enterprise Apps
Environmental and Sustainability
ESG
FashTech
FemTech
Financial Planning
Financial Services
FinTech
Food and Beverage
Food Security
Games/Gaming
Gender/Sexuality
Global Leadership
Green Building
Green Consumer Goods
Green Financing
GreenTech
Healthcare/Public Health/Womens Health and Reproductive Justice
Human rights/Social justice
Internet Of Things
Journalism
Language Learning
Law/Policy/Advocacy/Government/Politics
Machine Learning
Manufacturing
Medical
Medical Device
Microfinance
Molecular Biology
Nanotechnology
Natural Beauty
Nutrition
Payments
Pets
Pharmaceuticals
Product Design
Product Positioning
Publishing
Racial Equity/Diversity and Inclusion
Real Estate
Renewable Energy
Retail
Robotics
Sales
Science/Biology and Chemistry
Smart Power
Solar and Wind Energy
Telecommunications
Transportation
Violence prevention/anti-human trafficking
Women and girls leadership and empowerment
22
What is your area of expertise?
Accounting
Advertising
Advisory Services
Analytics
B Corp Certification
Billing
Board/Governance
Branding
Business Development
Business Plan
Capital Markets
Capital Restructuring
Clinical Research
Coaching
Compliance
Contracting
Corporate Finance
Corporate Law
Customer Service
Cybersecurity
Database
Data Privacy
DEI
Design
Digital Marketing
Digital Transformation
Employee Benefits
Enterprise Software
Entrepreneur
ESG
Evaluation/Measuring Success/Impact
Event Planning
Executive Coaching/Organizational Development
Finance
Financial Modeling
Financial Planning
Financial Services
Franchising
Fund of Funds
Fundraising/Philanthropy
Government Relations
Growth
GTM Strategy
Human Resources/Recruiting/Retaining Top Talent
Impact/Social Investing
Industrial Design
Infrastructure
Innovation
Investing
Investment Banking
IT/Informatics
Leadership
Legal
Logistics
Management
Management Consulting
Management of Staff/Teams and/or Projects
Marketing/Communications/Social Media
Media/Entertainment
Medical Device
Mergers and Acquisitions
Metrics and KPI
Operations
Organizational Development
Partnerships
Patents and Licensing
Payments
Philanthropy
Pitch Development
Pricing
Privacy
Private Equity
Product Design
Product Development
Product Management
Public Policy
Public Relations
Public Speaker/Leadership Presence
Real Estate
Research
Retail/Distribution
Risk Assessment and Management
SaaS
Sales
Security
Social Media
Software Engineering
Start-Ups
Strategic Partnerships/Networks
Strategy
Succession Planning
Supply Chain
Sustainability
Systems Engineering
Tax Planning
Tech Innovation
Technology/Biotech
Thought Leadership
UI Design
Wealth Management
Web Design
Web Services/IT Services
23
Which board role are you interested in?
Advisor
Observer
Board Director
Chair
24
What type of experience have you had with boards?
Advisor
Observer
Board Director
Chair
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