Name
*
First Name
Last Name
Email
Briefly describe why you are interested in a board position with Roots.
Equity and inclusion are important aspects when working with families in the perinatal period. Please share your thoughts on equity, inclusion and justice and how you could help make our team more equitable and inclusive?
Please list your current employer(s) / organizational affiliations (names of the organization and your role(s)
Which of your skills would you like to utilize on the Board? Check all that apply
Are there any other skills you will bring to the Board?
Participating in the Board of Roots is also an opportunity for individual growth by being part of a compassionate, honest, and dynamic team. What do you hope to gain from your participation on the Board, e.g., what types of experiences, skills to develop, interests to cultivate for you, etc.?
If you become a board member at Roots, can you prioritize a commitment of at least 2-4 hours a month in attendance at Board and Committee meetings, as well as additional hours as necessary?
Yes
No
Do you have any conflicts-of-interest that we should be aware of? Please state them below.
If you are not selected as a member of the Board, or if you decide not to join, would you like to be a volunteer to assist our organization in various ways that match your skills and interests?
Yes
No
