Board Member Application Form

Do you have skills, experience and interest in helping to govern and shape the direction of Big Brothers Big Sisters of Guelph? If so, you might be a great fit for our board of directors, which is currently seeking applications for two new directors. The board meets once a month and each director is expected to sit on at least one additional committee (fundraising, finance, EDI, etc.). Kindly complete the application form below, which will be delivered to the Executive Committee. Any questions, please contact Michael Treadgold, Executive Director.

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Date
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CONTACT INFORMATION
Full Name*
Gender*
Pronouns*
Primary Phone Number*
This is my*
- Cell Phone
- Home Phone
Email*
Address*
Apartment or Unit Number (if applicable)
City*
Postal Code*
Age: Please indicate your date of birth:*
To be a board member with Big Brothers Big Sisters of Guelph, you must be at least 18 years of age.
DD slash MM slash YYYY
Ethnic Identity (for demographic reporting purposes)*
- Black
- First Nations / Metis
- Inuit
- African
- South American
- Central American
- European
- Indo China
- Middle East
- Southeast Asian
- Asian - all other
- Pacific Islands
- American
- French Canadian
- English Canadian
- Undisclosed / Prefer not to say
- Other
Other Ethnic Identity
Do you speak any languages other than English?*
Are you employed?*
- Yes
- No
Agency/Employer*
If applicable
Position*
Work Phone Number*
GENERAL INFORMATION
Have you applied to be a volunteer with a Big Brothers Big Sisters agency in the past? If so, where?*
Were you referred to this opportunity by someone currently or formerly affiliated with Big Brothers Big Sisters of Guelph?*
- Yes
- No
What is the name of the individual who referred you?*
Statement of Intent*
Why are you interested in joining the Board of Directors for Big Brothers Big Sisters of Guelph?
Board members bring a variety of skills and experiences to the organization. Which of the following would you bring? (please check all that apply)
- Strategic Planning
- Other Boards/Leadership/Governance
- Financial/Accounting
- Risk Management
- Legal
- Human Resources
- Fundraising
- Social Services/Program Delivery
- Marketing/Communications/Public Relations
Please list any clubs, affiliations or organizations of which you are a member
EDUCATION
Please indicate your highest level of completed education*
- High School
- Trade School
- College
- University
EXPECTATIONS
Board members are expected to commit to a minimum 2-year term with the organization. Are you able to make this commitment?*
- Yes
- No
Are you anticipating any changes in your life in the next year that might impact your ability to be consistent in your role as a board member with Big Brothers Big Sisters of Guelph (e.g. marital status, living arrangements, employment, children, and/or graduation)?*
- Yes
- No
Please provide as much detail about these changes as you feel is necessary*
Are you available to volunteer in the summer?*
- Yes
- No
REFERENCES
Please provide contact information for the following references. All references must be over the age of 18. Character references must have known you for at least 2 years and preferably not be related to you.
1. Character Reference
This should be someone who knows you well and can speak to the kind of person you are, such as a close friend.
Name*
First Last
City of Residence*
Primary Phone*
Email Address*
Years Known*
Please enter a number greater than or equal to 2.
Relationship to you*
2. Character Reference
This should be someone who knows you well and can speak to the kind of person you are, such as a close friend.
Name*
First Last
City of Residence*
Primary Phone*
Email Address*
Years Known*
Please enter a number greater than or equal to 2.
Relationship to you*
3. Employment/Volunteer Reference
This should be an employer or volunteer supervisor.
Name*
First Last
City of Residence*
Primary Phone*
Email Address*
Years Known*
Relationship to you (e.g. Supervisor)*
Permission
The information in this application is true to the best of my knowledge. I hereby waive the right to request disclosure of the personal information given about me by the individuals indicated above.
Type Your Name (First & Last)*
Signature*
SMS Verification - please provide mobile number*
Today's Date*
DD slash MM slash YYYY
IMPORTANT:*
- By checking this box, I acknowledge that I have read the Volunteer Permission and Release Agreement (accessed through the button below), have been given an opportunity to obtain independent legal advice, and understand that it represents a waiver of certain of my legal rights, including my right to sue (subject to local laws). I further agree that such limits are reasonable and sign this Agreement freely, voluntarily and without duress.
Name
This field is for validation purposes and should be left unchanged.

Read the Volunteer Permission and Release Agreement

CONTACT INFORMATION

GENERAL INFORMATION

EDUCATION

EXPECTATIONS

REFERENCES

1. Character Reference

2. Character Reference

3. Employment/Volunteer Reference

Permission