2021 DEVELOPMENT COMMITTEE APPLICATION

This is an application for individuals interested in joining SBA's Development Committee.

Applications due: February 8, 2021

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* 1. Name:

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* 2. Gender:

Male

Female

I prefer not to answer

Other (please specify)

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* 3. Contact Information

Address:

City:

State:

Zip:

Email:

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* 4. What is your relationship to Spina Bifida? Check all that apply.

I am an adult with Spina Bifida

I am or was a parent or caregiver of a child or adult with Spina Bifida

I have or had a friend with Spina Bifida

I have or had a family member with Spina Bifida

I am a medical professional who works with the Spina Bifida community

I work with the Spina Bifida community in another capacity

I have no connection, but care about the cause

Other (please specify)

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* 5. What is the highest level of education you have completed?

High school graduate or GED

Some college or technical school

College graduate

Post graduate degree (MA/MS/MBA, PhD, MD, JD, etc.)

I prefer not to answer

Other (please specify)

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* 6. What is your current employment status?

Full time

Part time

Retired

Unemployed

I prefer not to answer

Other (please specify)

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* 7. If you work full or part time, please tell us about your current employer.

Company Name:

Title/Position:

City:

State:

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* 8. In which of the following industries have you ever been employed? Check all that apply.

Banking/Finance

Education

Fundraising/Development

Government

Health Care

Hotel/Lodging

Insurance

Non-Profit Management

Real Estate

Restaurant/Food Service

Retail/Sales

Other (please specify)

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* 9. Have you ever served as a member of an advisory board, committee, or board of directors for a non-profit or for profit organization?

Yes. Please indicate the organization(s).

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* 10. If you answered yes to the previous question, please indicate the position(s) held.

President

Vice President

Secretary

Treasurer

Chair

Member

Other (please specify)

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* 11. As a member of the organization(s) above, did you ever fundraise?

Yes

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* 12. If you answered yes, approximately how much money did you raise? Please explain.

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* 13. In which of the following areas do you have fundraising experience?
Check all that apply.

Special events (galas, auctions, etc.)

Walks/Marathons

Securing individual major gifts ($1,000 or more)

Securing corporate donations

Foundation proposal writing

Direct mail

Telemarketing

Online peer-to-peer fundraising

Other (Please specify)

2021 DEVELOPMENT COMMITTEE APPLICATION

Question Title

* 1. Name:

Question Title

* 2. Gender:

Question Title

* 3. Contact Information

Question Title

* 4. What is your relationship to Spina Bifida? Check all that apply.

Question Title

* 5. What is the highest level of education you have completed?

Question Title

* 6. What is your current employment status?

Question Title

* 7. If you work full or part time, please tell us about your current employer.

Question Title

* 8. In which of the following industries have you ever been employed? Check all that apply.

Question Title

* 9. Have you ever served as a member of an advisory board, committee, or board of directors for a non-profit or for profit organization?

Question Title

* 10. If you answered yes to the previous question, please indicate the position(s) held.

Question Title

* 11. As a member of the organization(s) above, did you ever fundraise?

Question Title

* 12. If you answered yes, approximately how much money did you raise? Please explain.

Question Title

* 13. In which of the following areas do you have fundraising experience?
Check all that apply.

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* 14. Why do you want to join SBA's Development Committee?

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* 15. What qualities or experience would you bring to this committee?

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* 16. Have you read and familiarized yourself with the Development Committee Charge (Job Description) before submitting this application?

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* 17. Electronic Signature (print name)

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* 18. Today's date

2021 DEVELOPMENT COMMITTEE APPLICATION

Question Title

* 1. Name:

Question Title

* 2. Gender:

Question Title

* 3. Contact Information

Question Title

* 4. What is your relationship to Spina Bifida? Check all that apply.

Question Title

* 5. What is the highest level of education you have completed?

Question Title

* 6. What is your current employment status?

Question Title

* 7. If you work full or part time, please tell us about your current employer.

Question Title

* 8. In which of the following industries have you ever been employed? Check all that apply.

Question Title

* 9. Have you ever served as a member of an advisory board, committee, or board of directors for a non-profit or for profit organization?

Question Title

* 10. If you answered yes to the previous question, please indicate the position(s) held.

Question Title

* 11. As a member of the organization(s) above, did you ever fundraise?

Question Title

* 12. If you answered yes, approximately how much money did you raise? Please explain.

Question Title

* 13. In which of the following areas do you have fundraising experience? Check all that apply.

Question Title

* 14. Why do you want to join SBA's Development Committee?

Question Title

* 15. What qualities or experience would you bring to this committee?

Question Title

* 16. Have you read and familiarized yourself with the Development Committee Charge (Job Description) before submitting this application?

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* 17. Electronic Signature (print name)

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* 18. Today's date

* 13. In which of the following areas do you have fundraising experience?
Check all that apply.