1. General Information

Completion of this form DOES NOT guarantee your participation in the 2019 Board Summit. Organizations who complete this form by March 18, 2019, will be notified by March 29 as to whether they have been selected to be featured at the Board Summit. Selected organizations will be asked to submit a participation fee of $50 - $150, depending on their annual operating budget, in order to complete the registration process.

Nonprofits will be selected based on their readiness to provide interested candidates with a quality board recruitment and service experience. Organizations that demonstrate a commitment to building a diverse and inclusive board will be prioritized. An effort will be made to select a diverse group of organizations, representing many focus areas and organization sizes.

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* 1. Organization Information

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* 2. Type of Organization (pick all that apply)

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* 3. Geographic Area Served (pick all that apply)

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* 4. Primary Age of Population Served (pick all that apply)

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* 5. Organization's Mission (50 words - If selected, your organization's mission will be printed in the program as it is submitted here. For this reason, your mission must be stated in 50 words or less.)

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* 6. Year Organization was Established

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* 7. Number of Employees (including both full and part-time)

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* 8. Annual Operating Budget (for internal use only)

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