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Board Member Application Form

SECTION 1: PREFERRED CONTACT INFORMATION

Name(Required)
Preferred Mailing Address:(Required)

SECTION 2: EMPLOYMENT

Current employment status:(Required)
Business Address:

SECTION 3: MISSION ALIGNMENT

Have you interacted with our organization before applying for the board?(Required)
(examples: committee member, client, donor, event attendee, open house, challenge event etc.)
Board service is a true commitment of time and energy. AMIkids Board Members serve on at least one committee and attend meetings at least bi-monthly. In addition, we ask for attendance at periodic special events (such as graduations, fundraisers, annual board of trustee meetings, etc.) Can you make this commitment at this time?(Required)
Among other responsibilities, AMIkids Board Members are responsible for a meaningful financial contribution to the program. Gifts can come in the form of a contribution, either individually, through a foundation or fund controlled by the trustee, or through a business owned by the trustee. Additionally, each trustee may choose to solicit meaningful gifts to the program from individuals, businesses, and foundations within their sphere of influence but who are not AMIkids trustees or employees. The total sum of these solicited gifts will together fulfil the “Give and Get” Policy requirements. Gifts to the program may be in the form of cash or securities. The minimum required contribution for the Give and Get Policy will be set by each program’s Board of Trustees, and may change year to year. Can you make this commitment at this time?(Required)

SECTION 4: AREAS OF EXPERIENCE OR EXPERTISE

(Check all that apply)
(Please Include Organization Name, Role/Title, & Date of Service)

OPTIONAL INFORMATION

The following optional information is requested for use in grant and other solicitation application purposes. It is important for funders to understand board diversity and makeup when they are making funding decisions.

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