Board of Directors Interest Form
Whether you are self-nominating or you are nominating someone else, please fill out this form as completely as possible. Please note: Many people are nominated for a few open board positions. A rigorous selection process follows nomination, including screening and interviewing with current board members.
Date
-
Month
-
Day
Year
Date
Self-Nominating or Nominating someone?
Self-nominating
Nominating someone
How did you hear about this opportunity?
What interests you about Family Paths?
*
If nominating someone else, what is your name and contact information?
Nominee's Name
*
First Name
Last Name
Nominee's Pronouns (ex - she/her/hers, he/him/his, they/them/their)
*
Nominee's Email
*
example@example.com
Nominee's Phone Number
*
Please enter a valid phone number.
Nominee's Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nominee's Workplace Name, Position and Address (incl. City and Zip)
*
Nominee's LinkedIn URL and/or website URL
Nominee's Demographic Information
Age Group
*
Under 35
35-50
51-65
Over 65
Ethnicity
*
Asian/Pacific Islander
Black/African-American
Hispanic/Latinx
Multiracial/Biracial
Native American/Alaskan Native
White/Caucasian
Other
Gender Identity (ex - Cis Man, Cis Woman, Gender Neutral, Gender Non-Conforming Man/Woman, Non-Binary, Transfemme, Transmasc, etc.)
*
LGBTQ+
*
Yes
No
Unknown
Are you a parent or caregiver to a child?
*
Yes
No
Nominee could contribute expertise in the following areas (check all that apply):
*
Administration/Business Management
Community Outreach
Education
Fatherhood Specialist
Financial
Fundraising/Development
Government
Human Resources
Legal
Marketing
Media
Medical/Health
Mental Health/Social Services
Planning
Public Relations
Real Estate
Tech/IT
Other
Relevant professional and personal skills:
Other nonprofit or board experience:
Other affiliations (individuals, corporations, foundations):
Contacts outside the area and where?
Nominee would be an asset to Family Paths' Board of Directors because:
*
Additional Comments?
Submit
Should be Empty: