Board Interest Form for The Institute for Health and Social Equity, Inc. Question Title * 1. Full Name Question Title * 2. Preferred Email Question Title * 3. Phone Number Question Title * 4. Current Occupation / Title Question Title * 5. Current Organization / Employer (if applicable) Question Title * 6. LinkedIn Profile Question Title * 7. Which board role(s) are you interested in? (Select all that apply) President Vice President Treasurer Secretary General Board Member / Member-at-Large Question Title * 8. What motivates you to serve on the board? Question Title * 9. Have you ever served on a board before? Yes No Question Title * 10. If yes, please describe your experience. Question Title * 11. Please rate your experience in the following areas. (1-lowest with 5-highest) 1 2 3 4 5 Leadership & Governance Leadership & Governance 1 Leadership & Governance 2 Leadership & Governance 3 Leadership & Governance 4 Leadership & Governance 5 Strategic Planning Strategic Planning 1 Strategic Planning 2 Strategic Planning 3 Strategic Planning 4 Strategic Planning 5 Budgeting & Finance Budgeting & Finance 1 Budgeting & Finance 2 Budgeting & Finance 3 Budgeting & Finance 4 Budgeting & Finance 5 Fundraising & Development Fundraising & Development 1 Fundraising & Development 2 Fundraising & Development 3 Fundraising & Development 4 Fundraising & Development 5 Advocacy & Community Engagement Advocacy & Community Engagement 1 Advocacy & Community Engagement 2 Advocacy & Community Engagement 3 Advocacy & Community Engagement 4 Advocacy & Community Engagement 5 Communications & Social Media Communications & Social Media 1 Communications & Social Media 2 Communications & Social Media 3 Communications & Social Media 4 Communications & Social Media 5 Event Planning Event Planning 1 Event Planning 2 Event Planning 3 Event Planning 4 Event Planning 5 Policy/Legislative Experience Policy/Legislative Experience 1 Policy/Legislative Experience 2 Policy/Legislative Experience 3 Policy/Legislative Experience 4 Policy/Legislative Experience 5 Question Title * 12. What strengths, skills, or lived experiences would you bring to the board? Question Title * 13. With regard to time commitment, board members can expect:Quarterly board meetings (60–90 minutes each) with light preparation in advance.One annual strategic planning session (2–3 hours).Periodic input via email on policy briefs, partnerships, or program decisions—usually no more than 1–2 short requests per quarter.Light support with relationship-building and fundraising, which may include helping identify potential partners or sponsors. This is not a requirement to solicit funds—your role is simply to open doors when it feels appropriate.Optional participation in events, advisory conversations, or special projects aligned with your expertise.Overall, this averages to 2–4 hours per month, depending on your chosen level of engagement. Our goal is to keep the board’s work purposeful, meaningful, and directly tied to The Institute's mission, without creating undue burden on your schedule. Are you able to offer this level of commitment? Yes No Question Title * 14. What do you believe are the biggest opportunities for our organization in the next 1–3 years? Question Title * 15. How do you envision contributing to our mission during your board term? Question Title * 16. Is there anything else you would like us to know about your interest or background? End Page MessageThank you for your interest in board service!We will review your submission and follow up with next steps. Done