KCFEC Board Application Form

The Kansas City Free Eye Clinic is looking for board members who have a broad range of backgrounds, skills and expertise, and have the time to participate on a “working board.” We aim to bring diversity to enrich the organization from multiple points of view.

It is the policy of KCFEC to provide equal opportunities without regard to race, ethnicity, religion, national origin, gender, sexual preference, age, or disability.

Thank you for completing this application and for your interest in KCFEC.

Your Name:

First NameLast Name

Home Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Mobile Number:

Format: (000) 000-0000.

Preferred E-mail Address:

Provide the email that you check most often. It will be used for board portal access and marketing messages.

Google Login Email

Do you have a different email address you can use to log into our shared Google Drive to access documents?

Birth Date

MonthDayYear

Current Employment

Position & Employer

How did you learn about this opportunity?

i.e. please specify who/how you heard about serving on the Board

Boards provide governance and critical capital – intellect, reputation, resources, and access – to power nonprofit success and strengthen communities. The board balances its role as an oversight body with its role as a force supporting the organization.

We’ve structured our board commitments after examining what makes exceptional boards work well.

Here is a summary of those commitments that encompass the most important roles of board members: governing, sustaining, and serving as our brand ambassadors.

Member terms are two years long and members may serve for three consecutive terms (total six years)
Serve on one of three or more committee(s) for your term
- Governance: recruits new members, evaluates board performance, commitments, and engagement, and oversees strategic planning and organizational outcomes
- Internal Affairs: oversees financial, legal, risk management, evaluation of staff performance
- External Affairs: sets development and fundraising goals, assists with communications and marketing plans
- Additional Temporary Task Forces may be set up for projects such as audits, campaigns, nominating, etc.
Board meetings occur monthly and members are expected to attend at least 1/2 of scheduled meetings as well as actively participate among their committee(s)
Accept fiduciary responsibility for the organization, oversee its financial health & integrity, and participate in development efforts to ensure that we have the resources to meet the mission
“Give/Get:” Commit to a personal contribution that is significant to you, pledge to increase public support through targeted asks and major gifts from corporate sponsors, and seek in-kind goods & services
Members are expected to provide a monthly recurring donation in support of promoting cash flow as well as to major fundraisers
Participate in fundraisers and/or host small receptions to increase awareness and raise funds
Commit to increasing your skills as a board member by utilizing board resources for self education, learn about the organization’s mission and programs, and promote our work

I understand the commitments I am expected to make.

Experience

Please check the areas of expertise you can make to further our mission:

Please list current or prior board experience with other non-profit organizations. Please describe prior volunteering and fundraising experience that was significant and why it was meaningful to you.

Board members can expect to spend a substantial amount of time serving. What other commitments do you currently have? Please list any potential conflicts of interest or schedules to consider.

Why are you interested in serving as a board member at The Kansas City Free Eye Clinic?

As a board member would you be able to provide KCFEC no-cost or discounted access to any valuable services through your profession or relationships?

Please list the networks and groups you are a part of. Do you have any unique or special connections to local or national personalities?

Please share any other information you feel important for consideration for your application as a board candidate.

Additional information you would like to submit i.e. resume, prior projects, portfolio, etc.

Optional

References

Please list 2 references who are familiar with you.

Reference 1

Full Name & Relation to You

Contact Email & Phone Number

Reference 2

Full Name & Relation to You

Contact Email & Phone Number

The Kansas City Free Eye Clinic Board Application