White Bird Board of Directors Application

WHITE BIRD CLINIC – BOARD MEMBER APPLICATION
Thank you for your interest in serving as a member of the Board of Directors of White Bird Clinic. As a board member, you’ll be part of a group of decision-makers and can influence the current and future shape of White Bird Clinic. Completing this form will help you understand the skills and time/resource commitments of this position. You may find it helpful to read through the entire application and Board Member Responsibilities before you begin filling it out.

Applications are used by the Board to identify and evaluate potential board candidates. All new directors are elected by a majority vote of current board members.
BOARD MEMBER RESPONSIBILITIES

·       Prepare for meetings by reviewing agendas and materials beforehand.

·       Provide oversight and approval of White Bird Clinic's annual budget, audit reports, and key business decisions.

·       Partner with the Executive Director and other board members to achieve White Bird Clinic's strategic goals.

·       Assist in recruiting new board members to maintain a diverse and qualified board.

·       Advocate for White Bird Clinic's mission and vision to the community.

·       Uphold the highest standards of governance and accountability for White Bird Clinic.

. Contribute to the success of White Bird Clinic by serving on committees, task forces, and taking on special projects.

MISSION

White Bird is a collective environment organized to enable people to gain control of their social, emotional, and physical well-being through direct service, education, and community.

VISION

White Bird Clinic provides compassionate, humanistic healthcare, and supportive services to individuals in our community, so everyone receives the care they need.

VALUES

White Bird Clinic’s core values are compassion, client-centered care, community focus, individual empowerment, and service accessibility.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birthdate*

MonthDayYear
Date
Phone Number*

Area CodePhone Number
Email*
If currently employed, please list who you are employed with and your position/title and how long you've been employed at this company. (If you are retired, please provide details on your previous career)*
How long have you lived or worked in Lane County? *
What is your experience, understanding, or knowledge of White Bird? What aspect of White Bird interests you the most and why are you interested in serving on the White Bird Clinic Board?*
Please list any board service, volunteer work, special training, skills, professional membership, community activities, hobbies, special interests, or talents that may be useful to your board placement:*
Which of your skills would you like to utilize on the Board? Check those that apply*

Board developmentStrategic planningFundraisingFinancial managementCommunity networkingMarketingOther
White Bird serves many clients that are homeless, mentally ill, substance abusing, traumatized, or facing different hardships. What experiences have you had that draw you to help this population?*
What experience do you have with non-profits? Have you ever been on a governing board? Are you familiar with regulations governing anon-profit organization like White Bird?*
White Bird is moving from a consensus organization to a partly unionized, structured business with multiple programs and service areas. Have you participated in planned organizational change? If yes, what was your role and what did you learn? Have you ever worked as part of a union?*
From your knowledge of White Bird or the service delivery system, what do you think are challenges it faces and goals it should set? What is your long-term vision for White Bird’s role in our community?*
If you join the Board, you agree that you can provide at least 5-10 hours a month in attendance at Board and Executive meetings, responding to emails, and engaging with various board initiatives.*

Agree
If you join the Board, you agree that you do not have any conflict-of-interest in participating on the Board.*

Agree
Please verify that you are human*
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WHITE BIRD CLINIC – BOARD MEMBER APPLICATION