Trailblazers Board of Directors Nomination Form

Please fill out all fields below to the best of your ability for the person you are nominating (or about yourself if this is a self-nomination).  If you haven't already, please review the Trailblazers board nomination process found on our website at the following link.

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* 1. Please enter the first and last name of the person you are nominating.

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* 2. Please enter the email address of the person you are nominating.

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* 3. Please enter the phone number of the person you are nominating.

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* 4. Please indicate your nominee's age range.

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* 5. Please indicate their gender identity.

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* 6. Please indicate if they identify as any of the following. Check all that apply.

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* 7. Where do they reside?

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* 8. Are there any other distinguishing identifiers that might be pertinent to their service on the Trailblazers board? If so, please explain to the best of your ability.

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* 9. Skills/Areas of Expertise (Check all that apply.)

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* 10. Does your nominee have any other skills, areas of expertise, professional experience, or volunteer experience that might be pertinent to their service on the Trailblazers board? If so, please explain.

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* 11. Does your nominee have previous or current board experience?

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* 12. If yes, which boards? How many years have they served? What was/is their role? Did/do they serve on any committees?

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* 13. Why do you think your nominee would be a good fit for the Trailblazers board?

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* 14. Are there any potential conflicts that might impede your nominee from serving on the Trailblazers board? If so, please explain to the best of your ability.

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