Nonprofit Board Application PhoneThis field is for validation purposes and should be left unchanged.First Name*Last Name*Title*Email*Telephone Number*Organization*Organization Address*Organization Website*Impact Area* Animal Care & Services Arts & Culture Children’s Services Basic Needs Community & Capacity Building Diversity & Inclusion Education Environment Health Homeless & Housing Human Services Legal Services Literacy Poverty Senior Services Social Justice Other Operating Budget* Less than $100,000 $100,000 – $500,000 $500,000 – $1 million $1m – $2m $2m and above Board Make-up* 1% of my board are made up of people of color 5% of my board are made up of people of color 10% of my board are made up of people of color 20% of my board are made up of people of color 30% of my board are made up of people of color 40% of my board are made up of people of color 50% of my board are made up of people of color More 60% of my board are made up of people of color DEMOGRAPHICS OF CLIENTS ACTUALLY SERVED – If not collected, please respond to the best of your ability% White Anglo (non-Hispanic)% African-American (non-Hispanic)% Hispanic-Latino% Asian (non-Hispanic)% American-Indian (non-Hispanic)% Multi-Racial (non-Hispanic)% Other (non-Hispanic)DEMOGRAPHICS OF CLIENTS YOUR ORGANIZATION IS SUPPOSED TO SERVE – If not collected, please respond to the best of your ability% White Anglo (non-Hispanic)% African-American (non-Hispanic)% Hispanic-Latino% Asian (non-Hispanic)% American-Indian (non-Hispanic)% Multi-Racial (non-Hispanic)% Other (non-Hispanic)What makes your organization an ideal candidate for the First Look Assessment Program?What steps have you taken to make bring more representation to your board?Why is having representation from the community you serve important to your leadership?*Commitment Agreement – I agree to the terms and commitment for First Look – A Board Assessment Program. My organization agrees to the following:* Organizations must commit to the program. Organization’s executive director and board of directors must commit to participating in the program with a 100% participation rate. We believe that board members need to invest in this work to show their leadership and commitment to a culture change and support the organization on their path to community representation. Participants must commit to utilizing assessment tool: Intercultural Development Inventory (IDI). Participants must commit to take the time to read and understand and ask questions about their organizational assessment results. Participants must commit to attending program events and workshops. Final payments must be paid by end of program. (Does not apply to grant funded programming)
