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Board Member Application Form
THE BASICS
Name
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First Name
Last Name
Email
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Verify Email
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Address
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Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Phone
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Organization/Employer
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Your role in the Business / Organization
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WHO RECOMMENDED YOU FOR BOARD SERVICE?
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GETTING TO KNOW YOU
WHAT BROUGHT YOU TO US?
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What is your interest in Green Empowerment and motivation for deciding to fill out this application? Please share what about our thematic focus, geographic scope, approach, personnel, history, and/or organizational culture, excited you enough to prompt you to apply to be on the board?
WHAT CAN YOU BRING TO OUR TABLE?
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Please check any of the skills and expertise you will bring to Green Empowerment.
Public Relations / Marketing
Finance / Budgeting / Accounting
Public Policy / Advocacy
Legal Expertise
Public Speaking / Presentations
Event Planning
HR / Administration
Strategic Planning
Fundraising / Philanthropy
Information Technology
Professional Nonprofit Experience
Technical (i.e. renewable energy, water resource management, international development, watershed management/climate change mitigation)
Please describe how your experience has prepared you for Board Service with Green Empowerment:
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Resume
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Please attach your most recent resume and / or professional bio.
FINAL POINTS
English Proficiency
*
While Green Empowerment Board, staff and partners speak many languages. All board meeting materials and discussions are in English.
select one
Native/Fluent
Professional
Intermediate
Basic
None
Have you ever been convicted, plead guilty or plead no contest to a crime?
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(If yes, please explain)
Yes
No
If yes, please explain:
References
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Please identify at least two references we can speak with (name, contact info, relationship)