Barefoot Productions, Inc. DBA Creative Impressions
Board Member Application
Personal Information
Name
*
Last Name
First Name
Formal Title (e.g., Dr/Mr/Miss/Mrs/Mx)
*
Pronouns
*
Preferred Email for Board Correspondence
*
example@example.com
Personal Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
Alternate Phone Number
Format: (000) 000-0000.
Demographic Information
This section is OPTIONAL. Please keep in mind that many funders request information regarding our Board Members' personal information to assess our Board diversity.
Date of Birth
*
-
Month
-
Day
Year
Date
Gender Identity
*
Race
*
Black
White
Asian
Native American or Alaska Native
Native Hawaiian or Other Pacific Islander
Two or More Racer
Prefer Not to Say
Are you a military veteran?
*
Yes
No
Business/Work Information
Company/Organization
*
Title/Profession
*
Work Phone
Format: (000) 000-0000.
Briefly describe your professional background and current occupation:
*
Are you comfortable contributing financially to the organization, either through personal donations or by leveraging your network?
*
Yes
No
What motivated you to apply for a position on our board?
*
Have you served on any other non-profit boards? If yes, please provide details:
*
Our Board meets monthly - virtually. Are you able to commit to attending board meetings regularly? (Yes/No)
*
Yes
No
Is there anything else you would like us to know about you or your interest in serving on our board?
*
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