Board Member Application Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Employer Job Title I have expertise and/or experience in the areas of: Fundraising Accounting/Finance/Bookkeeping Public Relations Marketing/Communications Special Event Planning Administration Operations/Management Community Service Outreach Advocacy Special Education Supported/Customized Employment Grant Writing Policy Development Nonprofit Governance Program Development Interacting with people with DD Human Resources Other Other: Why are you interested in serving on the Mi Work Matters board? What do you hope to gain from the experience? How do you feel Mi Work Matters would benefit from your involvement on the board? Are you willing to give time, energy and resources to support the mission of MWM? Members stay connected to the organization through meeting attendance, committee work, membership events, email and other MWM communications. Do you have the time and resources to be an active member of the board? Board Service Time Committment * Board service requires attending 1 board meeting per month and serving on 1 committee. The minimum required time commitment is 4-5 hours per month. Some roles may require more time. Yes, I understand the time commitment and I am able to commit a minimum of 4-5 hours per month. No, I am unable to commit to 4-5 hours of time per month. Soliciting for membership and funding is an important requirement of board members. Are you willing and able to actively fundraise? Yes No Please describe experience you have had with solicitation: Please list board and committees you serve or have served on (business, civic, community, fraternal, political, professional, recreational, religious, social). List organization, role/title & years of service. List Education/Training/Certificates Once an applicant is approved as an active Board Member, (s)he is required to attend monthly board meetings, serve on a committee, participate in board education events and contribute to the sustainability of Mi Work Matters. Board terms are 3 years. By submitting this application you are verifying that all information provided is true. * Yes Thank you!
