1.I am interested in volunteering on the:

Board of Directors

Chatham Kent Community Impact Investments

2.I have experience in the following areas:

Financial statements, budgeting, internal controls, accounting policies, financial management or audit

Information technology and systems, data security, or change management

Marketing and communications

Fundraising

Government Relations

Other (please describe)

3.Are you a United Way ambassador?

I am a past or current United Way volunteer in Windsor Essex

I am a past or current United Way volunteer in Chatham Kent

I have attended United Way events, sponsored participants, or made donations to Windsor Essex

I have attended United Way events, sponsored participants, or made donations to Chatham Kent

4.Are you prepared to participate on a committee of the board as required as a member of the United Way Board of Directors if nominated?

Yes

No

5.Are you committed to be prepare for each meeting (e.g. reading meeting packages in advance)?

Yes

No

Yes

No

6.Are you prepared to commit to attending regularly scheduled meetings (e.g. 7:30-9:00am on the 4th Wednesday of the month)?

Yes

No

Yes

No

7.Briefly describe any past or current volunteer experience

8.Briefly describe any board or committee experience

9.Tell us more about you

I have personal or professional experience with children, youth, parent(s), or families

I live in a priority community (West Windsor, Downtown Windsor, Leamington)

I live in the Chatham Kent community

I experience(d) unequal economic, political, and social life due to race, ethnicity, colour, ancestry, place of origin, political belief, religion, marital status, family status, physical disability, mental disability, sex, gender identity or expression, sexual orientation, age, or class

10.What is your current (or most recent) occupation:

11.Contact Information

Phone Number:

Email:

What is the best time and day to reach you?

First Name:

Last Name: