Board Composition Matrix NEUAC strives to recruit and maintain a board with diverse talents, organization types, and geographic representation to support the goal of utility affordability for income-constrained households. We are committed to developing an inclusive board that reflects the communities served by NEUAC members. Use of Data: If information is used in any public way (e.g., NEUAC annual report), data will be reported only in aggregate. NEUAC staff will have access to board composition matrix data on an individual basis. Board members may also review individualized information or data summarized for a subset group where reasonable. For example, the Nominating Committee may review a summary of skills/demographics that NEUAC is "losing" with a group of board members whose terms end, in order to identify gaps to prioritize for new board member recruitment. And individuals' skills and interest in leadership roles may be considered by the board president in making committee assignments. Your Responses: Questions marked with an asterisk are required. All other questions are optional; you may answer or skip questions about personal demographic characteristics based on your preference. Board Member Question Title * 1. Board member completing this form Name Organization Question Title * 2. On which board does your organization serve? View the board lists here to confirm. Governance Board Advisory Board Ex Officio Board Organization CharacteristicsPlease answer the following questions in the context of your employer. Question Title * 3. Which best describes your organization? Community Action Agency Nonprofit Fuel Fund Other Nonprofit Organization Tribal Organization Local Government State Government Federal Government Utility (Investor Owned) Utility (Public Power) Utility (Co-op) Corporation Trade Association Other (please specify) Question Title * 4. If your organization is a utility, what resource(s) do you provide? Select all that apply. Electricity Natural Gas Delivered Fuels (Propane, Fuel Oil, Wood, Kerosene) Water Renewables (please specify) Other (please specify) Specify or provide other context Question Title * 5. In which states/locations does your organization operate? National Organization Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia (DC) 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 U.S. Territory Tribal Nation Other If you selected U.S. Territory, Tribal Nation, or Other, please specify: Individual CharacteristicsPlease answer the following questions about you as an individual.Demographics data will help NEUAC evaluate whether we represent the communities we serve and/or are missing important perspectives on our board. Question Title * 6. What is your age? ≤30 31-40 41-50 51-60 >60 Prefer not to answer Question Title * 7. What is your race? Select one or more, as applicable. Asian Black, African American Middle Eastern, North African Native American, Alaskan Native Native Hawaiian, Pacific Islander White Other (please specify) Prefer not to answer Question Title * 8. What is your ethnicity? Hispanic or Latino Not Hispanic or Latino Prefer not to answer Question Title * 9. What is your gender identity?Select one or more, as applicable. Female Male Non-binary Comments / Prefer to specify Prefer not to answer Question Title * 10. Do you identify as part of the LGBTQIA+ community?Select one or more, as applicable. Yes No Comments / Prefer to specify Prefer not to answer Question Title * 11. What is your veteran status? Actively serve in the U.S. Armed Forces, Reserves, or National Guard Veteran of the U.S. Armed Forces, Reserves, or National Guard I have not served in the U.S. Armed Forces, Reserves, or National Guard Other (please specify) Prefer not to answer Question Title * 12. Do you identify as a person with a disability or other chronic condition? Yes No Prefer not to answer If you would like to share, how would you describe your disability or chronic condition? (e.g., blind or visually impaired; experiencing hearing loss, deaf or hard of hearing; health-related disability; mental health condition; mobility-related disability) Question Title * 13. Have you personally experienced energy insecurity?For example, at any time in the past or present, you may have struggled to manage energy bills vs. other costs of living, been eligible for LIHEAP or other services, or experienced a utility shutoff. Yes No Prefer not to answer Comments Question Title * 14. Have you ever received LIHEAP or other utility assistance? Yes No Prefer not to answer Comments Question Title * 15. What are some areas of experience and interest where you can contribute to NEUAC? Select up to five. Experience may be through your professional work or volunteer roles. Accounting, financial management Event management Fundraising Fuel funds Governance, board management, nonprofit compliance Government relations, advocacy, lobbying Investment management Justice, equity, diversity, and inclusion Law, legal counsel LIHEAP Outreach, marketing, communications Public speaking Research and data Strategic planning Training and technical assistance, education Utility regulation, rate cases Water Weatherization Other (please specify) Question Title * 16. What are some of your community connections? Select up to five. Relationships could include members of the community, their advocates, or related social services organizations. These may be through your professional, volunteer or personal networks, which you could engage to support NEUAC's mission. For example, you may assist with developing annual conference content. Academia Community Action Agencies Disability, differently abled Faith-based organizations Government - federal level Government - state level (including utility regulators) Government - local level Healthcare, medical Housing Immigrants LGBTQIA+ Media Older adults Rural Single parent households Tribes Utilities Veterans Youth Other (please specify) Question Title * 17. Are you interested in future leadership opportunities with the NEUAC board?Select all that apply. Yes, officer Yes, committee chair Not at this time Other (please specify) Question Title * 18. Approximately how many years have you been involved in NEUAC?Your estimate can include NEUAC's predecessor organizations, the National Fuel Funds Network and National Low-Income Energy Consortium, if you were active prior to 2014. Done