Board of Directors Application
Fill the form below accurately indicating your potentials and suitability to position you are applying for.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
Email
example@example.com
WHICH BOARD ARE YOU INTERESTED IN?
Goverance Board
Fundraising Board
Youth Legacy Board
Advisory Board
How were you referred to us?
*
Walk-In
Referral
Newspaper Ad
Facebook
Twitter
LinkedIn
Other (please specify)
CURRENT OCCUPATION/PROFESSIONAL EXPERIENCE
HAVE YOU EVER SERVED ON A BOARD OF DIRECTORS BEFORE? YES/NO
YES
NO
IF YES, PLEASE LIST THE ORGANIZATION AND YOUR ROLE
EDUCATION
SKILLS AND EXPERTISE: SELECT ALL THAT APPLY
Financial Management
Strategic Planning
Governance
Fundraising
Marketing/Communication
Legal
Other
WHY ARE YOU INTERESTED IN SERVING ON OUR BOARD?
WHAT DO YOU HOPE TO CONTRIBUTE TO THE ORGANIZATION THROUGH YOUR ROLE?
HOW MANY HOURS PER MONTH CAN YOU DEDICATE:
ARE YOU ABLE TO ATTEND REGULAR BOARD MEETINGS?
Please Select
YES
NO
ARE YOU ABLE TO PARTICIPATE IN COMMITTEE WORK?
Please Select
YES
NO
REFERENCES
Please provide two references
Reference #1
Reference #2
DECLARATION
I declare that the information provided in this application is true and accurate to the best my knowledge.
Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please verify that you are human
*
Submit Application
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