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
*
Alternate Phone Number
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
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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