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* 1. First Name

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* 2. Last Name

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* 3. Email Address

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* 4. Phone Number

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* 5. Street Address

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* 6. City

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* 7. State

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* 8. Zip Code

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* 9. Birthdate

Date

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* 10. Gender

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* 11. Ethnicity

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* 12. Outward Bound Course Alumni

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* 13. Do you have another or different connection to Outward Bound?  If so, please share.

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* 14. Professional Background/Business Sector

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* 15. Career Summary (Linkedin profile link or Biography)

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* 16. Resume and/or Biography Upload

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* 17. My vision/priorities for OBUSA over the next three years is/are:

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* 18. I see my non-financial contributions to the OBUSA Board as:

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* 19. I would like to accomplish the following in my role as an OBUSA Board member:

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* 20. I need the following from the OBUSA Board to enable me to fulfull my role as a Board member:

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* 21. I will have a successful term as an OBUSA Board member if the following happens:

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* 22. Which of the following OBUSA Strategic Priority Skillsets can you contribute?

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* 23. Board Members are expected to participate in 4-6 meetings per year, 2-4 of these via video conference (typically 2 hours each) and 2 in-person at rotating sites around the country (typically 1.5 days each). If occasionally unable to attend in-person, Board members still participate via video conference. Additionally, Board Members serve on at least one Board Committee and attend 3-5 scheduled committee meetings throughout the year (typically 1.5-2 hours each). We strive to schedule all meetings a year in advance when possible. Do you have the time to commit to these meeting obligations?

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* 24. Board members are expected to make or leverage an annual financial contribution to the organization, and prioritize OBUSA as their most important charitable donation. Leveraging a gift can happen in many different ways including: securing valuable sponsorship for an OBUSA event, connecting the OBUSA Advancement office with a major donor within your network and helping to secure a donation, securing a donation through an employer program, and more. Can you commit to this annual finacial contribution expectation?

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* 25. Please add any other comments you'd like to share:

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