Board Candidate Information Form

Section I
Section II

Your significant employment history (begin with most recent):

  Employer Title Dates of Service
1.
2.
Section III
    Area of
Concentration		 Degree Year
Grad School
Grad School
College
Section IV

If you have had previous volunteer experiences, please list your involvements, including previous or current board experience - beginning with the most recent.

  Organization Role From To
1.
2.
3.
4.
5.

The remainder of this form is multiple choice, and should be quick and easy to complete!

Section V

From each category of skills listed below, check those that describe your background, training and experience.


 1100   MANAGEMENT   
 1001  CRISIS MANAGEMENT 
 2200  HUMAN RESOURCES/
 PERSONNEL 
 1004  STRATEGIC PLANNING 
 1008  QUALITY CONTROL 
 1011  TRAINING 
 OTHER       
 
 1900   FINANCE   
 1901  ACCOUNTING/AUDITING 
 1905  BUDGET & FINANCIAL
 PLANNING 
 1907  FUND ACCOUNTING 
 1911  INTERNAL CONTROL 
 1912  PORTFOLIO MANAGEMENT 
 1913  TAXATION 
 OTHER       
 
 2300   INSURANCE   
 2301  CASUALTY/LIABILITY 
 2302  EMPLOYEE BENEFITS 
 2303  MEDICAL INSURANCE 
 2304  PROPERTY INSURANCE 
 2305  RISK MANAGEMENT 
 OTHER       
 
 2600   LEGAL   
 2602  BANKRUPTCY 
 2605  CONTRACT/SALES 
 2617  LABOR/UNIONS 
 2621  NONPROFIT 
 2623  REAL ESTATE 
 2626  TAX 
 2635  MERGERS & ACQUISITIONS 
 2636  CORPORATE LAW 
 2640  INTELLECTUAL PROPERTY 
 2642  HEALTHCARE 
 2643  LITIGATION 
 2644  ENVIRONMENTAL LAW 
 OTHER       
 
 2500   LANGUAGES   
 2602  AMERICAN SIGN
 LANGUAGE/BRAILLE 
 2605  SPANISH 
 OTHER       
 
 
 
 2700   MARKETING   
 1111  DESIGN/LAYOUT 
 2701  ADVERTISING 
 2704  MARKET RESEARCH 
 2705  MARKETING 
 2707  MEDIA RELATIONS 
 2709  PRICING 
 2711  PROMOTIONS 
 2714  PRESS RELEASES 
 2725  COMMUNITY RELATIONS 
 OTHER       
 
 1100   WRITING/COMMUNICATIONS   
 1917  CLIENT BILLING 
 1118  FACILITATION SKILLS 
 1120  PUBLIC SPEAKING 
 1126  GRANT WRITING 
 OTHER       
 
 3500   REAL ESTATE/FACILITY
 MANAGEMENT  		 
 3502  ARCHITECTURE 
 3501  APPRAISALS 
 3503  BROKERAGE 
 3505  CONSTRUCTION 
 3511  LEASING 
 3513  PURCHASE/SALES 
 OTHER       
 
 1400   COMPUTER/INFORMATION
 MANAGEMENT SYSTEMS  		 
 1410  INTERNET/WEB PAGE 
 1404  COMPUTER PROGRAMMING
 & DESIGN 
 1411  NETWORKING 
 OTHER       
 
 4100   OTHER   
 1600  EDUCATION 
 2100  HEALTH & MEDICAL
 SERVICES 
 2805  FUNDRAISING 
 3401  ADVOCACY 
 3507  ENGINEERING 
 3700  SCIENCE 
 3814  HOTEL/RESTAURANT
 MANAGEMENT 
 3822  RESEARCH & DEVELOPMENT 
 3824  RETAILING 
 3826  TV/VIDEO/PSA
 PRODUCTION 
 OTHER       
A.)  Which skills do you most want to offer as a nonprofit board member?
 
B.)  Are there skills you do not want to offer?
 
C.)  If you have had previous experience with nonprofit organizations, please indicate the nature of the involvement below:

 

MARKETING       BOARD DEVELOPMENT
FUNDRAISING/DEVELOPMENT       FINANCE
CRISIS MANAGEMENT       EXECUTIVE DIRECTOR
MARKETING       STRATEGIC PLANNING

SECTION VI:
Please describe the kind of organization that interests you. Feel free to check multiple answers from each category:
 1000   ARTS, CULTURE
 & HUMANITIES  		 
 1002  ART 
 1005  DANCE 
 1006  ELECTRONIC MEDIA 
 1007  FILM 
 1303  HISTORIC PRESERVATION 
 1009  HISTORY 
 1011  LIBRARY 
 1013  MUSEUM 
 1014  MUSIC 
 1015  VISUAL 
 1017  THEATRE 
 1019  VOCAL/CHORAL 
 1020  PHOTOGRAPHY 
 
  		 IF APPLICABLE, SPECIFY TYPE
 OF MUSIC/ART: CLASSICAL,
 OPERA, CONTEMPORARY, ETC. 
    		 
 
 1200   EDUCATION   
 1201  ACCULTURATION 
 1202  ADULT/CONTINUING 
 1203  SCHOOL TO WORK 
 TRANSITION 
 1206  HIGHER EDUCATION 
 1207  PRESCHOOL EDUCATION 
 1208  PRIMARY EDUCATION 
 1209  SECONDARY EDUCATION 
 1210  STUDENT RETENTION 
 1212  LITERACY 
 OTHER       
 
 1500   HEALTH ISSUES   
 1502  DEVELOPMENTAL 
 DISABILITY 
 1504  HOSPITAL 
 1505  MENTAL HEALTH 
 1506  PHYSICAL DISABILITY 
 1507  PREVENTION/WELLNESS 
 1508  REHABILITATION 
 1510  LONG TERM CARE 
 1511  VISION 
 1512  HEARING/SPEECH 
 OTHER       
 
 1525   DISEASES   
 1501  AIDS 
 1513  SUBSTANCE ABUSE 
 1514  CANCER 
 1515  HEART 
 1516  LUNG 
 1519  ALZHEIMER'S 
 1522  DIABETES 
 1523  MULTIPLE SCLEROSIS 
 OTHER       
 1600   HUMAN/SOCIAL SERVICES   
 1521  FAMILY PLANNING 
 1601  ADOPTION 
 1603  NEIGHBORHOOD CENTERS 
 1605  CONSUMER ADVOCACY 
 1609  EMPLOYMENT/JOB TRAINING 
 1610  FAMILY 
 1611  FOSTER CARE 
 1612  HOMELESSNESS 
 1613  HOUSING/SHELTER 
 1514  HUNGER 
 1615  DOMESTIC VIOLENCE 
 1616  MEN 
 1619  PUBLIC SAFETY 
 1620  RECREATION/SPORTS 
 1621  SENIORS 
 1624  TEENS/YOUTH 
 1625  YOUNG CHILDREN 
 1626  WOMEN 
 1627  COUNSELING 
 1650  EMERGENCY SERVICES/SHELTER 
 OTHER       
 
 1300   ENVIRONMENT/ANIMALS   
 1302  CONSERVATION 
 1306  BEAUTIFICATION 
 1308  WILDLIFE 
 1315  ANIMAL CARE 
 OTHER       
 
 1800   RELIGION   
 1801  CATHOLIC 
 1802  JEWISH 
 1803  MUSLIM 
 1804  PROTESTANT 
 1806  LUTHERAN 
 OTHER       
 
 1100   CULTURAL   
 1101  AFRICAN AMERICAN 
 1104  HISPANIC 
 1105  MULTICULTURAL 
 OTHER       
 
 1900   OTHER   
 1401  ADVOCACY EFFORTS 
 1402  CIVIL RIGHTS 
 1403  COMMUNITY STABILIZATION/ 
 DEVELOPMENT 
 1405  FOUNDATIONS 
 1409  RESEARCH 
 1410  SCIENCE 
 OTHER       
  Please list your top three priority interests:
1.
2.
3.

SECTION VII:
A.) In terms of its budget, what size organization interests you?
 UNDER $100,000 
 100,000 TO 499,999 
 500,000 TO 999,999 
 1,000,000 TO 4,999,999 
 OVER 5,000,000 
 DOES NOT MATTER 
B.)
   		Some people prefer to work with an organization that is in a particular developmental stage. If you have a preference, please check below:
 START-UP 
 GROWTH 
 ESTABLISHED 
 UNDERGOING MAJOR TRANSITION 
 CRISIS 
 DOES NOT MATTER 
C.) How much time could you devote each month to your trustee activities?
 UNDER 4 HOURS 
 5-8 HOURS 
 9-12 HOURS 
 13-16 HOURS 
 OVER 16 HOURS 
 
D.)
   		Do you have preferred days and/or times to attend board meetings? (E.g., breakfast, lunch or evening? Days of the week?)
E.)  COUNTRY/CITY OF ORIGIN: 
    HOW MANY YEARS HAVE YOU LIVED IN THE AREA? 
FOR OUR RECORDS ONLY, THE FOLLOWING QUESTIONS ARE OPTIONAL:
WHAT IS YOUR DATE OF BIRTH:
WHAT IS YOUR ETHNIC BACKGROUND:
AFRICAN AMERICAN
ASIAN AMERICAN
HISPANIC
CAUCASIAN
OTHER