The Board Institute – Application – Hudson Valley Pattern for Progress

Candidate Application

The Board Institute Application

Applicant Name *

First

Last *

Last

Applicant Telephone Number *

Applicant Email *

Home Address - Street Address *

Home Address - City, State, ZipCode *

Applicant's Preferred Pronouns:

Applicant's Race & Ethnicity:

Asian/Asian American

Black/African American

Hispanic/Latinx

Middle Eastern

Native American/Alaskan Native

Multiracial

Other, please specifyOther, please specify

Employer

Job Title

Work Address - Street Address

Work Address - City, State, ZipCode

Work Telephone

LinkedIn Profile

Community Involvement & Volunteerism

Have you ever served on a Board of Directors?

Yes

No

Which Boards have you served on and for what terms?

Please upload your resume

Maximum file size: 516MB

Why do you feel drawn to Board Service? *

What types of organizations and community service do you feel most passionate about such as health, homelessness, hunger, arts, education, environment, religion, or international affairs? *

Board Service is a commitment of time, energy, and resources, are you prepared to dedicate time and leverage your network to support a non-profit? *

What skills/tools do you believe you need to take the next step to Board Service? *

REFERENCES

Reference One

First

Last

Title

Company/Organization

Email

Phone

Reference 2

First

Last

Title

Company

Email

Phone

If you are human, leave this field blank.