Board Member Application

Name

Address

Cell Phone

Email

County of Residence:

Chenango

Delaware

Madison

Otsego

Other…

Company/Place of Work:

Job Title or Description:

Work Adress:

Work Phone:

Why are you interested in serving on the Board of Directors of UWMRNY?

Please list any current or previous experience serving on a Board of Directors or Volunteering for a not-for-profit or other community organization:

Please list any other community organizations with which you are involved or affiliated (if not listed above):

Please identifyany skills or areas of expertise that you would bring to the Board of Directors of UWMRNY (for example, marketing, legal, HR, technology, finance, education, healthcare):

Please provide any other information you would like to share with UWMRNY:

The UWMRNY Board of Directors meets at least five times a year. Meetings usually occur via electronic video conferencing at alternate times (8:30am and 5:30pm) but may take place in person from time to time. Board members are expected to serve on at least one Board Committee or significant community impact project and to financially support the United Ways Annual Campaign with a donation (no specified amount). Board members are elected for a three-year term. Are you able to meet these commitments?

Yes

No

If you are not able to meet the Board service commitment, or if there are currently no open Board seats available, are you interested in volunteering in other ways, such as by serving as a community representative on a committee or volunteering for a special event?

Yes

No

A verity of factors must be taken into consideration by the Nominating Committee of the Board in determining who will be placed in nomination at any given time for a seat on the Board of Directors, including diversity, geographic community and county representation, as well as representation of important economic, cultural and other interests of the community. In addition, the board seeks to have members with a verity of skill sets that can best serve the various needs of the organization. Your interest is appreciated and consideration will be given to your application based upon these various factors and the current needs of the organization.

THANK YOU FOR YOUR INTEREST IN THE UNITED WAY OF MID NEW YORK,INC.

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