Nomination Form for Election to the Board of DirectorsJanuary 1, 2018

Nominee: NameNominator: Name

Occupation: OccupationTitle: Title Employer: Business NameAddress: Street Address City, State ZipPhone: (555) 555-5555Email: Email

Do you support Friendly House’s mission? ☐ Yes ☐ No

Why do you feel passionately about Friendly House’s mission?Click here to enter text.

What will you bring to the board? i.e.: skills, expertise, contacts, and resourcesClick here to enter text.

Committee interests: Please indicate your top two committee choices ☐ Finance ☐ Program & Planning☐ Facilities ☐ Fund Development ☐ Auction ☐ Board Resource☐ Equity & Diversity ☐ IT

Would you be willing to serve on the Executive Committee during one or more years of your term by chairing a committee or being an officer? ☐ Yes ☐ No Which role? Click here to enter text.

Are you able to attend board orientation during the 3rd week of September? ☐ Yes ☐ No

Are you able to attend the board retreat on a full Saturday in April?☐ Yes ☐ No

Are you willing to consider Friendly House number one or two among the nonprofits you support, in terms of your time and donations? ☐ Yes ☐ No

Will you attend Friendly House’s annual auction and invite at least 9 individuals to attend with you? ☐ Yes ☐ No

Are you willing to attend board meetings (Usually 9 per year, for approximately 2 hours)?☐ Yes ☐ No

Will you take your fiduciary responsibility seriously and seek out guidance if you don’t know how to read financial statements? ☐ Yes ☐ No

Will you respect the board’s consensus decision-making process? ☐ Yes ☐ No

If you are not elected to the board this year, are you willing to serve on a committee as a non-board member? ☐ Yes ☐ NoIf yes, which one: Click here to enter text.

How are you affiliated with Friendly House?☐ NW Neighborhood (as resident or business affiliate)☐ First Presbyterian Church☐ At Large☐ Other: Click here to enter text.