PURPOSE:

This form is designed: (1) to record your interest and willingness to serve as a Director; (2) to outline the responsibilities of a Director; and (3) to affirm your commitment to carry out the responsibilities of the position if you are elected to serve. Upon completion, return this form and a copy of your resume to Valerie Novak, President, at valerie@thetravelgoddess.net.

The Board of Directors is charged with the overall strategy, policy and financial operations of the organization. Service on the Board may lead to election to an officer position. In addition to attendance and service at all monthly EWR functions, the Board also meets monthly, and once every six months meets for longer, strategic planning retreats.

As a Director of the Executive Women’s Roundtable, you are expected to:

• Study and be prepared to discuss all materials sent to you prior to a meeting;
• Communicate regularly with board members (on email and/or on conference calls) regarding issues and questions relating to management and planning for the organization;
• Attend and participate in all scheduled meetings of the Board of Directors and in at least 90% of the meetings of the full EWR;
• Oversee and assist in the work of the committee(s) to which you are assigned; and
• Advocate the goals and mission of the Executive Women’s Roundtable.

Service on the Board is voluntary.

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CANDIDATE SELF-NOMINATION: Date: _____________

NAME ______________________________________________________________________

HOME ADDRESS _____________________________________________________________

_____________________________________________________________________________

TELEPHONE ________________ FAX _______________E-MAIL ____________________

WORK ADDRESS _____________________________________________________________

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TELEPHONE ________________ FAX _______________E-MAIL ____________________

CURRENT OCCUPATION AND POSITION: _______________________________________

_____________________________________________________________________________

CURRENT EMPLOYER: _______________________________________________________

SIZE OF EMPLOYER (NUMBER OF EMPLOYEES, LEVEL OF REVENUE): ____________________________________________________________________________

YOUR JOB RESPONSIBILITIES: _______________________________________________

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PLEASE ATTACH A RESUME LISTING YOUR PROFESSIONAL EXPERIENCE AND EDUCATION.

NAME ______________________________ NAME ____________________________

POSITION __________________________ POSITION _________________________

YEARS _____________________________ YEARS ____________________________

NAME ______________________________ NAME ____________________________

POSITION __________________________ POSITION _________________________

YEARS _____________________________ YEARS ____________________________

WHY ARE YOU INTERESTED IN BEING ON THE EWR BOARD OF DIRECTORS? (Use reverse side of page, if necessary).

BECAUSE THE EXECUTIVE WOMEN’S ROUNDTABLE VALUES DIVERSITY OF SKILLS AND EXPERIENCE, PLEASE LET US KNOW IF YOU WOULD BE BRINGING ANY PERSPECTIVE OR EXPERIENCE THAT MIGHT ENHANCE THE BOARD’S DIVERSITY. (Use reverse side of page, if necessary).

If elected to serve as a Director of the Executive Women’s Roundtable, I agree to fulfill the responsibilities of my position, as outlined above, and to faithfully and fairly support the policies, rules and procedures of the organization. If my situation changes, and I find myself unable to fulfill my responsibilities, I will notify the President and ask to be replaced for the remainder of my term.

SIGNED: _______________________________________ DATE: ________________