First & Last Name
Email Address
Phone #
Address
City
Zip
County
Preferred method of communication
Preferred method of communication:
Phone call
Text
Email
Social media
Social Media
How did you learn about the program?
Are you currently serving on a Board or Commission?
Pronouns
Please share your preferred pronouns:
She/Her
He/Him
They/Them
Other
What is your age?
Please Select
18-29
30-39
40-49
50-59
60-69
70+
What is your level of education?
Please Select
High School or Equivalent
Associate
Bachelor's
Master's
Doctorate
What is your current job title?
The Boards and Commissions Fellowship is a six-month commitment of up to 20 hours each month, with trainings held on the second Saturday of each month. Please tell us about previous commitments of this length you've participated in and what you learned from that experience.
Upon completion of the program, fellows are required to apply for an appointment to a board or commissions, do you have obligations that would hinder your ability to apply immediately after completing the program?
Effective board and commissions service requires listening to and consulting with all members of the community. Do you have experience working within communities different than your own? If so, please tell us about these experiences. If not, how would you build these relationships?
Please tell us the number one reason you want to be a part of the Boards and Commissions Fellowship Program?
What kinds of support would you need to have a successful experience during the Boards and Commissions Fellowship? Examples: I need an interpreter to fully understand trainings, I do not have a computer/laptop, I need fully accessible spaces (ramps & accessible restroom), I need text read to me, I cannot sit for long periods of time, I do not have reliable internet, etc.
Please list the contact information for two (2) references that can speak to your leadership skills, abilities, and commitment to a project (no direct family members/relatives, please). EMAIL ADDRESSES ARE PREFERABLE.
Do you have any obligations that would hinder your commitment to the Boards & Commissions Fellowship Program Kickoff Event (March 8th, 2025), as well as the Boards & Commissions Fellowship Program Graduation Ceremony (October 4th, 2025) in Greenville, NC? If so, please explain.
What is your shirt size? (B&C T Shirts are Unisex)
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