Board of Directors Interest Form

Board of Directors Interest Form
Thank you for your interest in serving as a member of the Board of Directors of Childhood Cancer Foundation of Southern California (CCFSC). Serving on the board is a rewarding experience and an opportunity for personal and professional growth. Completing this form will help you understand the commitments of this leadership position. You may find it helpful to read through the entire form and Board Member Responsibilities before you begin completing the form.

This form will be kept confidential and on file at the CCFSC office. Forms are used by the Board’s Nominating Committee to identify and evaluate potential board candidates. All new directors are elected by a majority vote of current board members.
BOARD MEMBER RESPONSIBILITIES

1. Serves a minimum of one (1) three-year term on the Board. Eligible to serve two (2) three-year terms if re-elected.

2. Attend monthly board meetings. The Board of Directors meets the 2nd Monday of every month from 6:00 p.m. to 7:30 p.m.

3. Makes a serious commitment to participate actively in Childhood Cancer Foundation family activities and fundraising events.

4. Stays informed about committee matters, is prepared for meetings, and reviews and comments on minutes and reports.

5. Participates in the advancement of the strategic plan of CCFSC including fundraising and member recruitment.

Mission: provide emotional, social, educational, and emergency assistance to families who have, or have had, a child with cancer.

CANDIDATE INFORMATION
Name*

First NameLast Name
Business/Company Name:
Position/Title:
Preferred Mailing Address: (select one)*

HomeBusiness
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Number of Years with Present Company:
Preferred Communication: (select one)*

HomeCellBusinessEmail
Home Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Business Phone Number
Please enter a valid phone number.
Email
example@example.com
Community Organization Involvement: (clubs,boards etc.)
Please list other interests, activities, and hobbies:

CANDIDATE QUESTIONNAIRE
Why do you wish to be on the Board of Directors?
What attributes do you feel you would bring to CCFSC as a Board Member?
Are you willing to give time, energy, and resources to support the mission of Childhood Cancer Foundation?
Members stay connected to the organization through meeting attendance, committee work, family events, e-mail and other CCFSC communications. Do you have the time and resources to be an active member of the CCFSC Board?
Are you comfortable soliciting others for membership and funding? Describe any experience in doing so.
Please include any other information below that you feel our Board should consider regarding your potential selection:
Signature

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Date

MonthDayYear
Date
Should be Empty:

Board of Directors Interest Form

CANDIDATE INFORMATION

CANDIDATE QUESTIONNAIRE