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This is intended for the personal use of: ___________________________ (Name) ___________________________ (Term) Important information about the Board of Directors and the organization: Chief Executive Officer:__________________ Office Phone:________________ Officers of the Board: | President: | __________________ | Phone: | __________________ | | Vice-President: | __________________ | Phone: | __________________ | | Secretary: | __________________ | Phone: | __________________ | | Treasurer: | __________________ | Phone: | __________________ | Regular Board Meetings Occur:_______________ Time:___________ My Committee Assignment(s) This Year: Committee | Chairperson | Phone | Meeting date/time | | ___________________ | _____________ | ___________ | ______________ | | ___________________ | _____________ | ___________ | ______________ | As a Board Member of the organization, I will (please check to indicate your agreement): □ Participate and be involved in local councils in my area. □ Lead in forming a local council, if none exists in my home county/city. □ Meet with funding sources in my area. □ Attend board meetings. □ Attend the organization’s state conference. □ Attend as many other organizational functions as possible. □ Ensure the financial health of organization through personal contributions, encouraging others to contribute, relaying funding opportunities to staff, and visiting funding sources together with staff. □ Participate in at least one board committee. □ Come prepared for board meetings, having read the minutes of the previous meeting, the financial reports, and other board information. Signed__________________________________ Date________________ | Service on other Boards: | _________________________ | | Other experience: | _________________________ | | Other information: | _________________________ | | Recommended for nomination | _________________________ | | Hold for future nominations | _________________________ | | Comments: | _________________________ | | _________________________ Board Prospector | _________________________ Date | Source: Huberman, B., Advocates for Youth, 2009.
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