subject_line
Prospective Board Member Profile
Name
*
Street Address
*
City
*
Zip Code
*
Home Phone
*
Cell Phone
*
Email Address
*
Employer / Occupation
*
Are you retired?
*
Yes
Noi
Current or last position held:
*
Business Address
*
Business Phone
*
Preferred mailing address:
*
Home
Buisness
Personal Information
Birthday (MM/DD)
*
Select age range:
*
21-30
31-40
41-50
51-60
61-70
71+
Ethnicity
*
African American
Asian
Caucasian
Latino/a
Multiracial
Prefer not to respond
Significant other's name
*
How long have you lived in Northern Colorado in years?
*
Professional Affiliations: (Please list associations with dates of membership)
*
Community Activities: (please list other non-profits and committees with dates of service)
*
Interests and hobbies:
*
What strengths/passions do you feel you bring t the Board to contribute to the success of the mission of the foundation and the Board of DIrectors?
*
Please rank in order your committee preference (1 being the most preferred):
Governance
Finance
Fund Development