Board Member Application Form

This form is intended for individuals who are interested in serving on the board of directors of a nonprofit organization. Your responses will help us understand your background, qualifications, and interests to determine suitability and alignment with our mission.

Applicant Information

Full Name: {fullName}

Email Address: {email}

Phone Number: {phone}

Address: {address}

Professional Background

Current Occupation: {occupation}

Employer/Organization: {employer}

Years of Experience: {yearsOfExperience}

Educational Background

Highest Degree Obtained: {highestDegree}

Institution: {institution}

Skills & Expertise

Please list any areas of expertise, professional skills, or knowledge you believe would be beneficial to our organization.

{skillsExpertise}

Other Board Experience

{#hasBoardExperience}Organization: {previousBoardOrganization}
Role: {previousBoardRole}
Years Served: {previousBoardYears}{/hasBoardExperience}

{^hasBoardExperience}No previous board experience.{/hasBoardExperience}

Interest and Motivation

Why are you interested in serving on our board?

{interestMotivation}

Conflict of Interest Disclosure

{^hasConflicts}I confirm that I am not aware of any conflicts of interest that would affect my service on this board.{/hasConflicts}

{#hasConflicts}Conflict Details: {conflictDetails}{/hasConflicts}

Preferred Areas of Involvement

{#preferredAreas}

• {area}

{/preferredAreas}

References

Certification

I certify that the information provided in this application is true and complete to the best of my knowledge.

Applicant Signature: {applicantSignature}

Date: {applicationDate}