WPBDF BOARD OF DIRECTORS

Application to Serve on the WPBDF Board of Directors

Please complete and submit this survey if you are interested in serving on the Western Pennsylvania Bleeding Disorders Foundation's Board of Directors. The Board of Directors will review applications and those chosen to move onto the next round will be contacted for an interview.

As a member of the Board of Directors of WPBDF, you must be fully committed and dedicated to the mission of WPBDF:

WPBDF strives to enrich the lives of those with bleeding disorders in Western Pennsylvania and respond to the needs of the community in a dynamic environment.

Board Members help WPBDF carry out this mission, consistent with the functions of the office of board member as stated in WPBDF’s bylaws.

Please review the Board Member Expectations and Conflicts of Interest Policy before applying.

Question Title

* 1. Contact Information

Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

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* 2. Age

18-20

21-35

36-44

45-54

55-64

65+

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* 3. Have you ever served on an Advisory Board, Stakeholder Board or Board of Directors?

Yes

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* 4. If yes, please list your title(s), responsibilities, and dates of service

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* 5. Do you have volunteer experience?

Yes

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* 6. If yes, please list your volunteer experience below.

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* 7. Areas of interest or expertise (select all that apply).

Advocacy

Cinematology/Videography

Corporate Sponsorship

Event Planning

Finance

Fundraising

Governance

Grant Writing

Graphic Design

Insurance

Nonprofit Law

Photography

Public Relations

Health Care

Other (please specify)

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* 8. Are you able to actively serve for three years?

Yes

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* 9. Are you able to actively participate in Board Meetings?

Yes

WPBDF BOARD OF DIRECTORS

Application to Serve on the WPBDF Board of Directors

Question Title

* 1. Contact Information

Question Title

* 2. Age

Question Title

* 3. Have you ever served on an Advisory Board, Stakeholder Board or Board of Directors?

Question Title

* 4. If yes, please list your title(s), responsibilities, and dates of service

Question Title

* 5. Do you have volunteer experience?

Question Title

* 6. If yes, please list your volunteer experience below.

Question Title

* 7. Areas of interest or expertise (select all that apply).

Question Title

* 8. Are you able to actively serve for three years?

Question Title

* 9. Are you able to actively participate in Board Meetings?

Question Title

* 10. Is there any other information you would like to share?