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 prior experience serving on a nonprofit board?

Yes

No

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

Yes

No

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

Yes

No

Board members are expected to contribute to fundraising efforts, either through direct contributions or participation in events and campaigns. Are you comfortable fulfilling this expectation?

Yes

No

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 Board Member

I agree

I disagree