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Application for Board of Directors
Name
Preferred Name (if different)
Email
Phone
Mailing Address
City
State
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
Current Employer / Organization (if applicable):
Job Title / Role
Relevant Professional Background or Experience: (Briefly describe your work history, areas of expertise, or leadership roles. Highlight anything relevant to food insecurity, nonprofit work, equity, community organizing, finance, law, public heRelevant Professional Background or Experience: (Briefly describe your work history, areas of expertise, or leadership roles. Highlight anything relevant to food insecurity, nonprofit work, equity, community organizing, finance, law, public health, etc.)alth, etc.)
Why are you interested in joining the board of this organization?
What skills or perspectives would you bring to the board? (Check all that apply or expand in writing below.)
Strategic Planning
Fundraising / Development
Financial Oversight
Legal / Compliance
Community Organizing
Public Health
Lived Experience with Food Insecurity
Marketing / Communications
Nonprofit Governance
Advocacy / Policy
Other:
Have you previously served on a nonprofit board?
Yes
No
If yes, please list the organization(s) and your role(s):
Are you able to commit to attending quarterly board meetings and participating in at least one committee?
Yes
No
Unsure — please contact me to discuss further
Is there anything else you’d like us to know?
Click below to confirm the information is correct and we have permission to contact you.
Date
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