Project Blueprint Application Question Title * 1. Personal Contact Information Name Company Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Country Email Address Phone Number Question Title * 2. Profile Age Gender Ethnicity/Race Question Title * 3. How did you hear about Project Blueprint? Question Title * 4. Education Background High School Graduate Some College Bachelors Degree Masters or Advanced Degree Professional Certifications Question Title * 5. Employment Present Employer Number of Years Job Title Business Address City/Town State/Province ZIP/Postal Code Country Email Address Phone Number Question Title * 6. Preferred email address Personal Business Question Title * 7. Skills and Experience No Experience Moderate Experience Considerable Experience Finance/Accounting Finance/Accounting No Experience Finance/Accounting Moderate Experience Finance/Accounting Considerable Experience Legal Legal No Experience Legal Moderate Experience Legal Considerable Experience Public Relations Public Relations No Experience Public Relations Moderate Experience Public Relations Considerable Experience Fund Development Fund Development No Experience Fund Development Moderate Experience Fund Development Considerable Experience Human Resources Human Resources No Experience Human Resources Moderate Experience Human Resources Considerable Experience IT/Technology IT/Technology No Experience IT/Technology Moderate Experience IT/Technology Considerable Experience Strategic Planning Strategic Planning No Experience Strategic Planning Moderate Experience Strategic Planning Considerable Experience Management Management No Experience Management Moderate Experience Management Considerable Experience Question Title * 8. Do you have any experience serving on a Nonprofit Board of Directors? Yes No Question Title * 9. Describe your volunteer service. Question Title * 10. What motivates you to volunteer? Question Title * 11. Why do you want to serve on a nonprofit Board of Directors? Question Title * 12. Statement of Commitment Yes No I am committed to attend each session I am committed to attend each session Yes I am committed to attend each session No I intend to serve in a leadership role in my community I intend to serve in a leadership role in my community Yes I intend to serve in a leadership role in my community No Question Title * 13. We will provide meals at each session. Please let us know if you have any dietary restrictions. Done
