Caucus Core Interest Form SECTION 1: Basic Information Question Title * 1. Full Name: Question Title * 2. Pronouns: Question Title * 3. Phone Number: Question Title * 4. Email Address: Question Title * 5. Neighborhood / Community Area: Question Title * 6. How did you learn about the Caucus CORE Open Call? SECTION 2: Connection & Engagement Question Title * 7. Have you previously participated in any Chicago Black Gay Men’s Caucus programs or events? Yes No Question Title * 8. If yes, please describe your involvement: SECTION 3: Leadership & Experience Question Title * 9. What skills or experiences would you bring to Caucus CORE?(Examples: community outreach, event planning, policy advocacy, fundraising, communications, facilitation, finance, etc.) Question Title * 10. How do you practice accountability in leadership spaces? SECTION 4: Alignment & Values Question Title * 11. What does community-centered leadership mean to you? Question Title * 12. How do you embody trust, visibility, and commitment in your work or personal life? Question Title * 13. What does the mission of the Chicago Black Gay Men’s Caucus mean to you personally? SECTION 5: Capacity & Commitment Question Title * 14. Are you able to commit to: Yes No Monthly CORE meetings? Monthly CORE meetings? Yes Monthly CORE meetings? No Active participation in outreach initiatives? Active participation in outreach initiatives? Yes Active participation in outreach initiatives? No Collaborative leadership and accountability standards? Collaborative leadership and accountability standards? Yes Collaborative leadership and accountability standards? No Question Title * 15. If yes, please describe. SECTION 6: Interview & References Question Title * 16. Are you willing to participate in an interview with Caucus leadership? Yes No Reference (optional but encouraged):Name / Organization / Contact Info Optional Add-On: Community Vision Question Question Title * 17. In one paragraph, describe your vision for the future of Black gay leadership in Chicago. Thank you for your interest in serving on Caucus CORE.Our leadership team will review applications and selected applicants will be invited to interview. Done
