Board of Directors Candidate Application

Thank you for your interest in becoming a board member for Covered, South Florida.  Please review the Board Member Responsibilities and Board Profile.  Applications are due by March 15, 2021. Contact us at AppointingCommittee@jlbr.org with any additional questions or inquiries.

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* 1. Today's Date

Date

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* 2. Please provide your personal contact details.

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* 3. Please provide your professional information.

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* 4. Please send my correspondence to my:

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* 5. How did you hear about Covered, South Florida?

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* 6. What skills do you have that would benefit Covered, South Florida? How do you feel these skills would bring value to the organization?

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* 7. Describe your involvement in the community. Please include board involvement, volunteer activity, memberships, etc.

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* 8. Background & Skills - Please indicate your areas of expertise, interest or both.

  AREA OF EXPERTISE AREA OF INTEREST
ACCOUNTING/TAXATION
ADVERTISING
ADVOCACY
BANKING
COMMUNITY ORGANIZATIONS
CORPORATE BUSINESS
CULTURAL ACTIVITIES
DEVELOPMENT / FUNDRAISING / PHILANTHROPIC ACTIVITIES
EDUCATION / PROGRAM PLANNING
FINANCIAL MANAGEMENT / FISCAL PLANNING
HEALTH & WELFARE
HUMAN RESOURCES
INSURANCE
LEGAL
MARKETING
MEDICINE
NEIGHBORHOOD ADVOCACY
NONPROFIT MANAGEMENT
POLITICS/GOVERNMENT
PUBLIC RELATIONS/MEDIA
REAL ESTATE
RELIGIOUS LEADERS
RESTAURANT/CATERING
SOCIAL CONTACTS / FINANCIAL CONTACTS
SOCIAL SERVICES

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* 9. Do you have relationships with potential funders and donors?

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* 10. Is there any other information you feel would make you a good Board candidate?

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* 11. Are you interested in serving  in any of the following leadership roles? Select all that apply.

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* 12. I acknowledge and agree that if selected as a Board Member, I shall serve a one year term starting January 1, 2022.

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* 13. I acknowledge and agree that if selected as a Board Member, I am required to invest $1,000 each year as part of my board giving requirements. This can be a give or get contribution.

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* 14. Please upload your bio or resume. Place your name in the title of the attachment. File size limit is 16MB.

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* 15. Please upload your headshot. Place your name in the title of the attachment. File size limit is 16MB.

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* 16. By entering my name into the below box, I acknowledge that I have read, understand and agree to the Covered, South Florida Board Member Responsibilities.

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