Board Leadership Institute Application

Contact Information *

First Name Last Name Email

Workplace *

Company or Organization Name Title / Role / Profession

Which of the following best describes your professional experience? *

Early career (1 - 7 years professional experience)
Advancing career (8-15 years professional experience)
Established career (15+ years professional experience)

Would you be interested in Board placement matches based on your home location? *

Yes
No
No preference

Your home zip code *

Your gender *

Female
Male
Other

I identify my gender as

Your ethnicity (select all that apply) *

Asian
Black/African American
Hispanic/Latino/a
Native American
Pacific Islander
White/Caucasian
Middle Eastern
Mixed Rrace
Other (please specify)

Other ethnicity

Voluntary Self-Identification

United Way is committed to the diversity and inclusion of individuals with disabilities. If you would like, please let us know whether you identify as having a disability. You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. (Note: a list of possible disabilities is listed at the end of this application)

Yes, I have a disability or history/record of one
No, I do not have a disability or history/record of one
I do not wish to answer

Please tell us a little more about your previous experience and interest in this program.

Why are you interested in serving on a nonprofit Board? *

Describe your volunteer/community involvement and/or philanthropic experience. Please indicate whether you have ever served on a nonprofit Board, Associate Board, or Junior Board, and in what capacity. *

What does civic engagement mean to you? *

How did you hear about this opportunity?

Please upload your resume here. *

Max. file size: 256 MB.

Acknowledgement of fee structure and application submission *

Interested applicants should seek sponsorship from their company to cover the course fees as outlined on the program overview page. Applicants who are not able to obtain sponsorship from their workplace should contact caitlin.closser@liveunitedchicago.org. Submission of this application does not guarantee placement in the program.

I confirm that I am aware of the course fee structure and application submission process.

Voluntary Self-Identification Disabilities

Disabilities include but are not limited to: Autism, Autoimmune disorder (for example, lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS), Blind or low vision, Cancer, Cardiovascular or heart disease, Celiac disease, Cerebral palsy, Deaf or hard of hearing, Depression or anxiety, Diabetes, Epilepsy, Gastrointestinal disorders (for example, Crohn's Disease, or irritable bowel syndrome), Intellectual disability, Missing limbs or partially missing limbs, Nervous system condition (for example, migraine headaches, Parkinson’s disease, or Multiple sclerosis (MS)), Psychiatric condition (for example, bipolar disorder, schizophrenia, PTSD, or major depression)

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Voluntary Self-Identification Disabilities

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