Thank you for your interest in the Fuqua On Board program. Before completing this form, please review the program description available at http://www.FuquaOnBoard.org.

After completing this form, please send your RESUME to CASE at fob@fuqua.duke.edu (see detailed instructions regarding your resume at the bottom of this survey).

We will contact you to arrange an interview to learn more about your interests and preferences during mid to late September.

Finally, please note that a $20 application fee is due at the time of your interview. Please bring cash or a check made out to "Duke University" (with "Fuqua On Board" written in the memo line).

Thanks!

The CASE Team

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* 1. First Name:

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* 2. Last Name:

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* 3. Class or Affiliation:

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* 4. Section (if First Year):

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* 5. E-mail address:

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* 6. Telephone: (Cell Number Preferred)

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* 7. Which concentration(s)/certificate(s), if any, are you likely to pursue while enrolled in The Duke MBA? [NOTE: It is okay if you are not yet certain which concentration(s) you will pursue, if any. For this question, please indicate those concentrations for which there is a high probability that you will select.]

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* 8. Is there another student with whom you wish to be paired?

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* 9. EXPERIENCE. For each of the following, please indicate the amount of experience you have had, if any. [NOTE: Prior experience is not a pre-requisite for participation in Fuqua On Board, but this information can be helpful in matching students and organizations.]

  None Less than 1 Year 1-2 Years 3-5 Years 6-9 Years 10 or More Years
Nonprofit Volunteering
Nonprofit Paid Staff
Nonprofit Board Experience
Corporate Board Experience
Strategy Consulting
Organizational Development Consulting
Other Business Consulting

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* 10. Please briefly describe your past volunteer or paid experience with nonprofit organizations, if any, including previous experience on nonprofit boards. Where possible, please include the names of the nonprofits with which you have worked or volunteered. [NOTE: Past experience with nonprofits is not a pre-requisite for participation in FOB.)

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* 11. Why do you want to participate in the Fuqua On Board program?

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* 12. What do you hope to learn during the program?

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* 13. What is your perspective on the state of management and governance of nonprofit organizations?

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* 14. Please rate your level of interest in the following fields / mission areas:

  1. High 2. Somewhat High 3. Neither High nor Low 4. Somewhat Low 5. No Interest Uncertain
Education / Literacy
Economic Development
Disabilities / Mental Health
Arts
Housing
Animal Welfare
Community Development
Nonprofit Support Organization
Public Affairs
Women / Girls
Youth Development
Homelessness/Basic Needs
Substance Abuse
Health
Environment / Conservation

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* 15. What other fields or mission areas interest you, if any?

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* 16. Please indicate your preliminary preferences among the nonprofits participating this year. You may list more than one organization as your 1st choice or 2nd, etc. (NOTE: This ranking is not binding on your final decision. After your interview, you may revise your preferences as needed.)

For a description of each organization, please open up a new window in your browser and go to http://FuquaOnBoard.posterous.com/

(NOTE: That document will be updated if additional nonprofits join the program in the next two weeks).

  1st Choice 2nd Choice 3rd Choice 4th Choice (if any) 5th Choice (if any)
Boy Scouts of America, Occoneechee Council
Bull City Forward
Calvary Ministries of the Westend Community, Inc. (Lyon Park Community Center)
Caring House
Carter Community School
Clean Energy Durham
DiabetesSisters
Dress for Success Triangle NC
Durham Crisis Response Center
Durham Economic Resource Center (DERC)
Durham Interfaith Hospitality Network
Durham Literacy Center
Durham Nativity School
El Centro Hispano, Inc.
El Futuro, Inc
Exploris Middle School
Forest at Duke, The
Genesis Home
Habitat foir Humanity of Durham, Inc
i4m
Junior Leadership Durham
KidZNotes
Maureen Joy Charter School
Museum of Life and Science
North Carolina Community AIDS Fund
Piedmont Wildlife Center
Scrap Exchange, The
Threshold
Triangle Champions Track Club
Triangle Family Services, Inc.
Triangle Land Conservancy
TROSA Inc
Urban Ministries of Durham
Walltown Children's Theatre

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* 17. If you are interested in one or more specific organizations that does not / do not appear above, please record the names of those organizations in the box below.

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* 18. Please rate your level of interest in the following types of committees or project team assignments.

  1. High 2. Somewhat High 3. Neither High nor Low 4. Somewhat Low 5. No Interest Uncertain
Human Resources
Fundraising Strategy
Business Planning / Strategy
Managerial Accounting
Organization Development
Board Development / Governance
Marketing
Program Evaluation
Grant Writing
Performance Measurement
Finance
Membership Development
Earned Income Strategies

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* 19. What other types of committees or project team assignments would interest you, if any?

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* 20. For each of the following pairs, please indicate which end of the spectrum you find most appealing.

  Prefer A Strongly Prefer A Slightly Indifferent Prefer B Slightly Prefer B Strongly UNCERTAIN
(A) PRE-STRUCTURED EXPERIENCE (i.e., clearly defined roles, goals, expectations up front, etc.) versus (B) UNSTRUCTURED (i.e., you must negotiate roles and goals with the organization)
(A) TASK ORIENTATION (i.e., focus on producing specific deliverables) versus (B) PROCESS ORIENTATION (i.e., learning about nonprofit governance and making general contributions to board decision-making)
(A) STABLE BOARD AND ORGANIZATION versus (B) TRANSITIONAL (i.e., recent changes in leadership/strategy, start-up, etc.)

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* 21. Comments on your preferences and answers to questions above, if any. (For example, do you have special skills, experiences, interests, or other factors that make you a good fit for one or more of the organizations you have selected above?)

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* 22. Is there any other information that we should know to help us match you with an appropriate organization?

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* 23. Program Expectations & Norms: For each of the following, please confirm that you understand these expectations by checking YES or NO as appropriate.

  YES NO
FOB is an extracurricular volunteer program; you will NOT receive academic credit
You should expect to volunteer 12-14 hours per month, including time at board and committee meetings and at FOB training workshops and other sessions
Attendance at workshops and peer networking sessions is a required; if you are unable to attend, you must notify CASE
Although the FOB program does NOT include full-scale consulting project, you WILL be expected to make meaningful contributions to a board committee, task force, or project team and provide a final report
Brief progress reports will be required at the end of Terms 2 & 3
In the event that you have difficulty in your FOB placement, you should contact CASE for assistance
Thank you for your thoughtful responses to this survey.

Your application will NOT be considered complete until we receive your RESUME at fob@fuqua.duke.edu. Before sending, please name your file following the convention: LastName_FirstName_MM-DD-YY.doc or LastName_FirstName_MM-DD-YY.pdf (Please note that your resume does not have to be in the Fuqua-standard format required by the CMC--any conventional resume will be fine.)

We will contact you in mid September to schedule an interview. You may change or update your preferences among nonprofits after your interview.

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