Saskatoon Council on Aging (SCOA) Board of Directors

Statement of Interest Form

Thank you for your interest in joining a non-profit Board! Please use this form to provide useful information about yourself to the Saskatoon Council on Aging (SCOA) Board of Directors Nomination Committee.

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* 1. Address

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Briefly describe what prompts you to want to join the SCOA Board of Directors:

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* 3. Please list your current organizational affiliations (names of the organization and your role(s): e.g. Saskatoon United Way - Volunteer

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* 4. Which of your skills would you like to utilize on the Board? Check those that apply:

Interest in and experience with older adults including programming and/or care

Board development and governance

Strategic planning

Financial management

Fundraising

Leadership skills – SCOA officer positions

Research and Evaluation

Training, technology

Marketing, public relations

Community networking

Staffing / HR

Program development

Other skills of yours that you would like to utilize?

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* 5. What would you like to get for yourself out of your participation on the Board, e.g., what types of experiences, skills to develop, interests to cultivate for you, etc.?

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* 6. If you join the Board, you agree that you have no conflict-of-interest in participating on the Board and can provide at least 3-5 hours a month in attendance to Board and Committee meetings.

Yes

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* 7. When is the best time to meet with you?

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* 8. If you are not selected to the Board this year, or if you decide not to join, would you want to be a volunteer to assist our organization in various ways that match your skills and interests?

Yes

Maybe

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* 9. Would you agree to be contacted again next year?

Yes

Maybe