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Board of Directors Applicant Form
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Personal Information
Name
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Email Address
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Home Address
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Age
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65+
Demographic Information
How long have you lived or worked in Contra Costa County
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Pronouns
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Work/Business Information
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Title/Profession
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Business Email
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Street Address
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American Samoa
Arizona
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California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
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Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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Montana
Nebraska
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New Hampshire
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New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Relevant Experience
Please list your current and past Board experiences
What are your current associations and/or club affiliations? (include titles if possible)
Please list your skills and expertise
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What is your educational background?
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Please describe in details some of your greatest strengths and weaknesses
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What do you feel is essential to ensure that the Contra Costa Crisis Center Board and staff are successful in attaining the goals for this organization?
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What experiences, expertise, connections, or resources would you bring to the Contra Costa Crisis Center?
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Please detail your interest in joining this Board
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What type of Board tasks do you prefer?
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Please let us know if you have any specific project ideas you would like to propose
Have you ever been engaged in any specific fundraising efforts? If so with whom, how, and what was the amount raised?
The Company Board is implementing 4 standing committees: (1) Fundraising and Donor Care (2) Finance & Human Resources, (3) Board Governance & Development and (4) Marketing & Programs. Please check all that you would be interesting in joining.
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Fundraising and Donor Care
Finance and Human Resources
Board Governance and Development
Marketing and Programs
Other
How much time would you have to dedicate to the company (a week, a month, etc…)?
The Contra Costa Crisis Center Board is an exciting and engaged working board. Board members generally meet for 10 - 12 monthly board meetings (zoom and/or in-person), and a minimum of quarterly committee meetings, which occur outside of regular board meetings (this can happen by phone or zoom). Board members are expected to be timely and present at every meeting with a maximum of three absences from board meetings. Between work within and outside of meetings, hours of commitment would probably vary between 3-5 hours per month. Board members are also encouraged to participate in fundraising and development activities, which include an annual gift to the Contra Costa Crisis Center that is personally significant and meaningful. Board members are expected to commit to the role fora minimum of one year. Will you be able to make this commitment to the Contra Costa Crisis Center?
Yes
No
Maybe
Acknowledgement
After your application has been reviewed you may be asked to interview in order for us to better get to know you. Please have a list of references available upon request. Thank you for your interest.
I certify, by my signature, that the information contained within this application and all supporting documents (i.e., resume, recommendation letters, etc.) is true, accurate, and complete to the best of my knowledge.
I acknowledge that I am submitting this form for Contra Costa Crisis Center board member consideration.
Date of Aplication
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