Board Application

If you are voted onto the Board, you will join a dedicated Founding Board of Directors and contribute to building, leading and governing Birth Detroit. Your role will include co-creating strategy, setting policies, cultivating resources, and other work to advance the mission and vision of Birth Detroit. Please complete this application and submit it with your resume to leseliey@birthdetroit.com.

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* 1. Please enter your contact information below.

Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country

Email Address *

Phone Number *

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* 2. What is your current occupation and employer?

Current occupation

Employer

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* 3. Areas of Expertise (select all that apply)

Business/Corporate

Event Planning

Education & Training

Financial Management

Fundraising

Government

Public Speaking

Policy Development

Social Entrepreneurship

Human Resources

Information Technology

Public Relations/Marketing

Non-Profit Management

Philanthropy

Volunteer Coordination

Parenting

Capital Campaigns

Strategic Planning

Evaluation

Legal

Community Organizing

Health Equity

Health Care

Pregnancy, Birth

Other areas of expertise/skills (please specify)

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* 4. How did you learn about Birth Detroit?

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* 5. What is your current relationship to Birth Detroit?

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* 6. History of Community/Volunteer Service

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* 7. Membership in Civic/Professional Associations

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* 8. Prior Board Experiences

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* 9. Special Interests/Hobbies

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* 10. Why are you interested in serving on the Birth Detroit Board of Directors?

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* 11. What areas of Birth Detroit Board service interest you most? (Please rank order.)

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* 12. Are you interested in chairing a committee? If yes, which of the above areas?

Yes (please specify)

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* 13. How will being a Board member be good for you personally?

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* 14. Birth Detroit aspires to build a Board on which all members contribute equitably to creating a strong financial foundation to support the mission. Members will be asked to contribute by making or raising an annual contribution that is comfortable for them and their families. Will making a personal “write or raise” commitment that you set be manageable for you?

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* 15. Birth Detroit is committed to creating and nurturing a culture of solidarity, equity, belonging, and shared leadership with respect to all aspects of social and cultural identity. Please describe your social and cultural identities.

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* 16. Please share anything else you would like us to know as we consider your application for Birth Detroit’s founding Board of Directors.

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* 17. If selected, can you attend Board meetings on the first Saturday of the month from 10am - 12pm (noon)?

Yes

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* 18. Please share two references: At least one should be from someone with whom you have worked in an employment capacity or as part of a team.

Reference 1 Name

Reference 1 Email

Reference 1 Telephone Number(s)

Reference 2 Name

Reference 2 Email

Reference 2 Telephone Number(s)

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* 19. Please allow my name to stand for nomination to the Birth Detroit Board of Directors. I am willing to commit my time, energy and passion to advance the mission of Birth Detroit.

Signature

Date