Board of Directors Application -

Contact Information

Name*

Prefix First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

What is the best way for us to contact you?*

Email
Phone

Employment Information

Name of Employer

Occupation/Title

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Work Phone

Does your employer offer any of the following? (please check all that apply)

Corporate Sponsorships
Matching Gifts
Grants

Areas of Expertise/Skills/Connections (please check all that apply)*

Other expertise, skills and connections you will bring to board service with Deborah’s Place?

What are your previous volunteer experiences or leadership roles?

Are you a member of any Civic/Professional/Alumni Associations? (please list)

Can you commit a minimum of 4-8 hours a month to Deborah’s Place?*

Yes
No

Do you understand the fundraising expectations for Board Membership?*

Yes
No

Are you able to participate in other fundraising activities? (e.g. attending events, making donor thank you calls, etc.)*

Yes
No

Respect for All

Deborah’s Place believes that achieving the organization’s mission of ending homelessness for women in Chicago requires varied voices, perspectives, skills and experiences. As the governing body, the board is committed to leading from the top to promote respect for all within our organization. Please enter N/A to decline a response.

Please share your personal pronouns (e.g. he/him, or she/her, or they/them, etc.)*

Please attach a copy of your resume*

Accepted file types: doc, docx, pdf, Max. file size: 50 MB.

file types: doc, docx, pdf

Optional Demographic Information

This information is kept confidential and will only be used in aggregate to report on the demographics of our board to government and private funders. Your participation is greatly appreciated.

Birthdate*

Race/and or Ethnicity

Gender

Sexual Orientation