HSRC Prospective Board Director Interest Survey

Welcome and thank you for your interest!

Please provide the following contact information. Note that upon election to the Board, this information will be used in the following ways:

Your name, title and work history summary will be placed on HSRC Board Director Roster which is made available to Board Staff.
Your address and cell phone number will be used for internal purposes only.
Materials will be sent to your email and physical addresses per your preference.

If you would like to learn more about HSRC, please visit:

http://www.humsenior.org

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* 1. +Please provide the following contact information

Name

Organization

Address

City/Town

ZIP/Postal Code

Email Address

Phone Number

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* 2. Please check the statements you can support.

I believe in developing and supporting an effective network of support for seniors which brings quality services to Humboldt County elders.

My schedule allows me to attend Board meetings, typically via Zoom, for 2 hours starting at noon on the last Thursday of the month.

I am willing to learn and apply Carver Governance Model principles.

I am willing to serve on a committee.

I am willing to undergo a background check.

I am willing to commit to a three-year term.

If you responded with Yes to 5 or more of the questions above, you are a strong Board Candidate for HSRC.

Please share more about yourself with us.

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* 3. Do you currently have an affiliation with HSRC? If so, please describe your current relationship.

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* 4. Why would you like to be a Board Director at HSRC?

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* 5. What skills, expertise and/or perspectives would you like to share with HSRC?

Accounting

Affiliations

Community Relations

Education

Facilities

Fundraising

Investment

Law

Lobbying

Management

Marketing

Personnel

Project Planning

Public Relations

Public Speaking

Real Estate

Team Building

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* 6. What would make this a satisfying Board experience for you? Have you thought about specific board committees on which you would be interested in serving? Do you anticipate that you would want to grow into an officer position within the board in the future?

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* 7. Please describe involvements with other organizations, both past and present, as well as professional accomplishments and/or educational experience.

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* 8. Would you be interested in being paired with a peer mentor upon election to the board?

Yes

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* 9. Please write a statement to seniors in Humboldt regarding your interest, abilities and capacity to serve as their Board representative.

Thank you for taking time to tell us about you. We will be reaching out soon to get to know you better.