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Prospective Board/Committee Member Information Form
The Gathering Outreach Community Center (GOCC) is a 501(c)3 nonprofit organization creating togetherness, wholeness and opportunities for the community to enhance the quality of life. GOCC has a mission to be the voice of love and the advocate of hope for those suffering with hopelessness, depression, low self-esteem, loneliness and anxiety.
The purpose of this information form is to enable the current GOCC Non-Profit Board to make appropriate choices of Board
Members for service to GOCC and the community for a 12 month term. Applicants interested in serving as a board member should first read and understand the expectations of Board Membership, read and understand the By-Laws, and submit a completed information form before April 22,2018. Applicants may also submit references or letters of recommendation for consideration.
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GOCC Board Member/Committee Expectations
* Support the Mission Statement of GOCC.
* Actively engage and recruit volunteers to participate in GOCC events
* Work as a part of a cohesive team with common goals
* Share his/her skills and expertise
* Dedicate time to GOCC board meetings
* Respect and support the majority decisions of the Board
* Volunteer and assist in GOCC youth engagement programs and
activities, include fundraising efforts
* Participate actively in Board meetings, actions, fundraisers and public
events
* Have no more than three (3) consecutive absences from board or
committee meetings
* Remain aware of the activities that are planned
* Do your best to ensure that the GOCC's Initiative is well-maintained,
financially secure, growing and always operating in the best interest of
the community
***If you are accepted as a GOCC Board/Committee Member, a full criminal background check will be conducted.
Name
*
Your answer
Mailing Address
*
Your answer
Contact Number
*
Your answer
Email address
*
Your answer
Current Employer/ Occupation/ Position
*
Your answer
Please check area(s) of expertise/contribution you feel you can make to further the mission of GOCC.
Youth Outreach/ Advocacy
Nonprofit Experience
Youth Programs / Events
Fundraising
Strategic Planning
Graphic Design/ Technology
Finance/ Accounting
Personnel / Human Resources
Community Service
Policy Development
Social Media / Communications
Education / Instruction
Grant Writing
Other:
Please list boards and committees that you serve on, or have served on (business, civic, community, fraternal, political, professional, recreational, religious, and social)
Organization / Role / Dates of Service
Your answer
What other volunteer commitments do you currently have?
*
Your answer
Why are you interested in serving as a Board member/Committee Member for GOCC?
*
Your answer
How do you feel GOCC would benefit from your involvement on the Board /Committee?
*
Your answer
Please list any groups, organizations or businesses that you could serve as a liaison on behalf of GOCC.
*
Your answer
Please share any other information you feel important for consideration of your application to serve as a GOCC Board member /Committee Member:
*
Your answer
Please review and respond to the following questions. Use a separate sheet as necessary
Are you aware of any information about yourself, which might tend to reflect unfavorably on your reputation, morals, character or ability as a board member for GOCC?
Yes
No
If yes, please explain.
Other:
Clear selection
Have you ever been convicted of a felony?
Yes
No
If yes, please explain.
Other:
Clear selection
Have you ever been convicted of a controlled substance offense?
Yes
No
If yes, please explain.
Other:
Clear selection
Have you ever been convicted of a sex-related crime?
Yes
No
If yes, please explain.
Other:
Clear selection
Are you willing and able to attend board meetings?
Meetings will be held at least 1-2 times a month.
Yes
No
Clear selection
Are you willing to interact with parents, children, and fellow board members professionally, with love and respect?
Yes
No
Other:
Clear selection
Are you willing to interact with parents, children, and fellow board members fairly and with love?
Yes
No
Clear selection
Are you willing to uphold the responsibilities assigned to you?
Yes
No
Clear selection
By typing my name below, I attest that the information I have provided is true and correct. Additionally, my online information submission represents my agreement to the following statements: I understand and agree to the GOCC Initiative Board Member Expectations; I agree to participate pursuant to the Policies, Procedures and Bylaws of the GOCC Initiative Board; and I understand that if conflicts prevent me from performing the rules and expectations as a Board Member, I may be removed from the Board by a majority vote.
Yes I agree.
No, I don't agree. I have additional questions.
Clear selection
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