Advisory Board Member Application

Name *

First Name

Last Name

Birthday

MM

DD

YYYY

Phone

(###)

###

####

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you have any affiliations, networks, or resources that could benefit NAIC?

Yes

No

What specific areas of NAIC’s work are you most interested in supporting?

Our Waters

Our Lands

Our People

Our History

Our Community

Other:

Are you willing and able to commit to attending monthly board meetings (in person or virtually)?

Yes

No

How much time per month can you dedicate to supporting NAIC initiatives (e.g., reviewing proposals, offering guidance, or attending events)?

1–2 hours

3–5 hours

6+ hours

Are you able to dedicate approximately 4-6 hours per month to board duties, including meetings, events, and committee work?

Yes

No

In what ways are you most comfortable supporting NAIC?

Providing strategic advice

Networking and introductions to resources

Advocacy and outreach

Serving as a subject matter expert

Supporting fundraising and events

Grant Writing and review

Other

Acknowledgment

By submitting this application, I affirm that the information provided is true and accurate. I understand the responsibilities and expectations of serving as an NAIC Advisory Board Member.

I agree

I disagree