Trustee Application Stonewall Columbus Board of Trustees Submission Form InstructionsPlease complete all required fields and then click submit. If you have any questions, please contact us at obneqerpehvgzrag@fgbarjnyypbyhzohf.bet. Please note: You cannot save this form and finish later – you must complete all fields to successfully submit.Contact InformationEnter all required contact information below.Your Legal Name (Last, First)*Preferred NameAddress* Street Address City State / Province / Region ZIP / Postal Code Evening Phone #*Daytime Phone #Email* Preferred Method of Contact* Email Phone OK to leave Board messages on your voicemail?* Yes No Demographic InformationAge Range* 18-29 30-54 55+ How do you self-identify? (check all that are applicable)* Gay Lesbian Bisexual Transgender Intersex Queer Heterosexual Ally Other specify Other response hereMy race/ethnicity is: (SWC must have this information to ensure diversity on its Board)* Asian/Pacific Islander Hispanic/Latino American Indian/Alaskan Native Black, not of Hispanic/Latino origin White, not of Hispanic/Latino origin Other specify Other response hereAre you currently employed? If so, please provide your employer and occupation.Please note that current employment is not a pre-requisite for selection as a Board of Trustees Member. This information is helpful for demographic reasons and to help identify corporate giving opportunities. However, this information is optional.Your Leadership & VisionWhat is your vision for Columbus’ LGBTQIA Community? In one year? In five years?*Why are you interested in serving on the Stonewall Columbus Board of Trustees?*What do you think are the primary responsibilities of a Stonewall Columbus Board of Trustees Member?*Have you volunteered with Stonewall Columbus in the past?*Enter ‘no’ or list your volunteer experience with Stonewall ColumbusStonewall Board of Trustee Members are expected to contribute to the organization’s success. In what ways would you do this? (i.e. skills, knowledge, monetarily, and/or expertise)*Attendance at monthly meetings is very important. Does your schedule permit you to attend all Board meetings, currently the 4th Wednesday of each month at 7:00 pm?* Yes No Initial Board terms are two years, with the opportunity to be re-appointed for a second term of three years. Are you able to commit to serve at least one full term of two years?* Yes No * If you are not selected for Board membership at this time, would you be interested in other volunteer work with SWC?* Yes No ReferencesPlease provide us with the names and contact information of 2 professional or personal references. If you were asked to apply by a current Stonewall Columbus Board of Trustee, please provide that Board member’s name as one of your referencesReference #1*Reference #2*Current Resume/CVUpload your Current Resume/CV*Max. file size: 50 MB. Board AgreementIf selected to serve on the Board of Trustees of Stonewall Columbus, I agree to participate in the training and orientation program for all Board members. I understand if I am unable to attend board meetings on a regular basis, I may be replaced as outlined in the Board’s by-laws. I also understand that I will be expected to participate on committee(s), raise or donate funds for the organization, and complete other assignments as needed.I agree to the terms of the Board Agreement* Agree Disagree Δ
