Board Member Application

Board Member Application
On behalf of everyone here at Iowa Bird Rehabilitation, thank you so much
for your interest in board service. We know that those with an interest in being a
leadership volunteer have many choices. In our community, there are an array of
remarkable organizations engaged in the important work of making our world a
better place. We are humbled knowing that you are interested in us.

The following application offers us an opportunity to know more about you, your
skills, attributes and what you would bring to our board. It also gives you a sense of what matters to us in any board candidate.

The goal of our process is to determine if we are a good fit for each other – your level of commitment and ability to deliver on our expectations so that we are confident that you can help us to increase the scope and impact of our work. On the other side, we want to know what motivates you and how you think about our organization so that we can help to create an excellent board experience for you.

Thank you again for your interest in our work and for taking the time to complete
this application with thought and care. We look forward to reviewing it with that
same level of thought and care and to continuing our conversations.
PERSONAL INFORMATION
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Mobile Phone
Please enter a valid phone number.
Preferred Method of Contact

Home PhoneWork PhoneMobile Phone
Email
example@example.com
Employment Staus

EmployedSelf-employedRetired
Employer
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type Of Business / Organization

VOLUNTEER EXPERIENCE

Past and Present Membership: boards, committees, task forces in the public sector (business, civic, community, religious, political, professional, recreational or social)

Add experience

	Organization	Role/Title	Date of Service
1
2
3
4
5
6
7
8
9
10

Other Volunteer Experience
WHY?

Those committed to volunteering in a leadership capacity have an abundance of organizations to choose from. We are most appreciative of your interest in ours and would like to hear more.
Why our organization and not any other? Please share your motivation and what it is about our work that has led you to raise your hand to be a leading ambassador for us.
OUR WORK
What excites you about the work of our organization?
What do you see as 1-2 challenges and 1-2 opportunities for us in the next few years?

FUNDRAISING
Among other responsibilities, board members play a key role in raising funds for our organization. It is an expectation of board service that you will introduce people in your sphere of influence to our work and invite them know and do more – as prospective volunteers, board members, staff and as donors. Our organization commits to providing you with the information and tools necessary for you to stand as a vocal and visible ambassador for our work.
Can you speak to your level of comfort with this expectation?
TIME

Board service is a true commitment of time and energy. We estimate that board service could be a commitment of 5 to 20 hours each month. In addition, we may ask for additional time for special events.
Do you have any concerns or potential conflicts that may serve as impediments to this time commitment? If so, how will you manage the demands on your time?
OTHER
Who recommended you for board service?
Have you ever been convicted, plead guilty or plead no contest to a crime?

NoYes
If yes,please explain?

Please identify at least two references we can speak with.

	Name	Relationship	Best Contact (Phone or Email)
1
2
3

RESUME

Please attach your most recent resume and / or professional bio.
Cancelof
Please verify that you are human*
Should be Empty:

Board Member Application

PERSONAL INFORMATION

VOLUNTEER EXPERIENCE

WHY?

OUR WORK

SKILLS / EXPERTISE

ATTRIBUTES

FUNDRAISING

TIME

OTHER