Connective Board Recruitment Form
Contact Details
First Name
Last Name
Phone
Email
Address
Apartment #
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Postal Code
Skills, Experience, and Availability
What is your employment status?
Full-time
Part-time
Retired
Other
If other, please describe.
What is your job title?
If retired, list your most recent job title and organization.
Current Organization
Which of the skills or experiences do you possess? Select all that apply.
Advocacy and Policy
Community Engagement
Design or Product Management
Disaster Recovery
Entrepreneurship
Executive Leadership
Finance
Housing or Development
Legal Expertise
Marketing & Communications (press, media, writing)
Non-Profit Experience: Board Membership
Non-Profit Experience: Management
Non-Profit Experience: Non-Board Volunteer Work
Technology or Software
Other
Please describe your other skill or experience
Do you currently serve on any other Boards?
Yes
No
How many?
Do you or your organization currently do business with/have an existing partnership with Connective?
Yes
No
How do you work with Connective?
What is the average amount of hours per month that you could commit to Connective?
2 - 5 hours
5 - 10 hours
Community Connections and Potential Committees
Do you identify as or have other significant work or lived experience with people who identify as any of the following?
Select all that apply.
Someone with Limited English Proficiency
Immigrants or Refugees
Disaster Survivors
Low to Moderate Income Residents
Persons with Disabilities
Member of the LGBTQIA community
Elderly Populations
Person or individual who has aged out of Foster Care
Person or individual with justice system involvement
If voted onto the Board, which of the following committees might you be interested in joining?
Outreach and Fundraising Committee
Innovation Committee (Program, Design, Technology)
Finance and Audit Committee
Governance Committee
Personal Demographics
At Connective, w
e strive to reflect our region's racial and ethnic diversity in hiring and board membership. The below optional questions will help us live up to this organizational goal.
What is your age group? (optional)
25 - 40
41 - 55
56 - 65
65+
Which of the following best describes your racial identity?
Select all that apply. (optional)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Multi-racial
Racial Identity not listed
I prefer not to say
Which of the following best describes your ethnicity? (optional)
Hispanic or Latino
Non-Hispanic or Latino
How did you hear about this Board opportunity?
Please select...
Current Board member referral
Social Media
Other
Contact Information