Girls For A Change Board Member Application Thank you for your interest in joining the Girls For A Change Board of Directors! Please complete this form in its entirety to help ensure the best match between you and Girls For A Change as we consider future candidates for our Board. Personal InformationName(Required) First Last Email(Required) Phone(Required)Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code If comfortable, please identify your racial, ethnic, and/or cultural background(s):GFAC uses this voluntary information to gauge its effectiveness in recruiting a diverse group of candidates. African American Hispanic/Latina/Latino Pacific Islander/Native Hawaiian African Native American/Alaska Native Asian American White/Caucasian Middle Eastern Other/Not listed Prefer not to answer Prefer to self-describe GenderGFAC uses this voluntary information to gauge its effectiveness in recruiting a diverse group of candidates. Female Male Transgender Non-confirming/Non-binary Prefer to self-describe If applicable, please provide us with your social media handlesTwitter, Instagram, Personal Website, Business Website, Facebook, LinkedInPlease upload a recent headshot(Required)Max. file size: 128 MB.Employment InformationCompany Name(Required) Current Job Title(Required) Current Company Start Date(Required) MM slash DD slash YYYY Are you self-employed?(Required) Yes No ExperienceDo you have current or previous board member experience, if so please describe Are you currently serving on a board, if yes when is your term ending QuestionnaireBriefly describe why you would like to join the GFAC Board of Directors:In what other ways do you support and help your community?Please list any current organizational affiliations:List the names of the organization and your role(s) on each line.Which of your skills would you like to utilize on the Board?Check all that apply. Board development Strategic planning Staffing / HR Program development IT/ Technology Financial management Fundraising Evaluation Community networking Legal Training Marketing Volunteer management Facilities management Policy. Advocacy Other skill(s) of yours that you would like to utilize? What would you like to gain from of your participation on the GFAC Board of Directors?E.g., what types of experiences, skill development, interests to cultivate, etc.?If you join the Board, you agree that you can provide at least 2-4 hours a month in attendance to Board and Committee meetings and that you do not have any conflict-of-interest in participating on the Board.(Required) Yes No If you are not selected to join the Board, or if you decide not to join, would you like to be a volunteer to assist our organization in various ways that match your skills and interests?(Required) Yes No Reference 1 (Required)Reference 1: Name(Required) First Last Reference 1: Email(Required) Reference 1: Phone(Required)Reference 2 (Required)Reference 2: Name(Required) First Last Reference 2: Email(Required) Reference 2: Phone(Required)SignaturePlease sign this form to acknowledge that the information provided within this form is true and correctSignature(Required)Today's Date(Required) MM slash DD slash YYYY Please answer the challenge below:EmailThis field is for validation purposes and should be left unchanged.