LeadUS Mentoring Program 2015-16

Nashville Main Street Board of Directors Applicant Form
Personal Information
Name

Last NameFirst Name
Date

MonthDayYear
Date
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Home Phone
Format: (000) 000-0000.
Birth Date*

MonthDayYear
Demographic Information
Place of Birth
Gender Identity

MaleFemaleOther
Ethnicity
Nationality
Business/Work Information
Title/Profession
Company Organization
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Work Phone
Format: (000) 000-0000.
Please list your current and past Board experiences
What are your current associations and/or club affiliations? (include titles if possible)
Please list your skills and expertise
What is your educational background?
Please describe in details some of your greatest strengths and weaknesses
What do you feel is essential to ensure that the Board and staff are successful in attaining the goals for this organization?
What experiences, expertise, connections, or resources would you bring to Nashville Main Street?
Please detail your interest in joining this Board
What type of Board tasks do you prefer?
Please let us know if you have any specific project ideas you would like to propose.
Have you ever been engaged in any specific fundraising efforts? If so with whom, how, and what was the amount raised?
How much time would you have to dedicate to Board meetings, committees, and events (a week, a month, etc…)?
The Nashville Main Street Board is an exciting and engaged working board. Board members are required to complete Main Street 101 training within their first term, and are also required to complete 2 hours of training per year. Board members are expected to be timely and present at every meeting (which take place on the first Tuesday of every month at 5:30pm) with a maximum of three absences from board meetings in the year. Board members must attend at least 75% of all scheduled events, which include but are not limited to community festivals, fundraising activities, board meetings, and other programs organized by Nashville Main Street. Between work within and outside of meetings, hours of commitment would probably vary between 4-8 hours per month. Board members are expected to commit to the role for a term of 3 years. Will you be able to make this commitment to Main Street Board?

YesNoMaybe
After your application has been reviewed you may be asked to interview in order for us to better get to know you. Please have a list of references available upon request.

Thank you for your interest.

I certify, by my signature, that the information contained within this application and all supporting documents (i.e., resume, recommendation letters, etc.) is true, accurate, and complete to the best of my knowledge. An electronic signature is accepted.
Signature
Date

MonthDayYear
Date
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Nashville Main Street Board of Directors Applicant Form

Personal Information

Demographic Information

Business/Work Information