WIIS Blue Book Form

Email*

Name*

First Last

Address*

Country of Residence*

U.S. State (if you reside in the USA)

City of Residence*

Phone Number*

Race and Ethnicity: (Select all that apply)*

Gender Identity*

Current Employer*

Professional Work Experience*

Board Members are often required to fundraise for their organizations. Are you willing to raise money for your organization?*

Expertise

To select multiples hold down: control and click (for PC) or command and click (for Mac)

Describe a professional or volunteer experience that you feel qualifies yourself for service on a board:*

Upload Bio*

Documents MUST be a PDF or Microsoft Word Document. Please upload the file with the format LastNameFirstNameBio.

Upload CV*

Documents MUST be a PDF or Microsoft Word Document. Please upload the file with the format LastNameFirstNameCV.

LinkedIn Address