Help Make a Difference

All of our volunteers are very important to us

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MEMBER APPLICATION




Name ___________________________________________________________________________

Age                  Under 30   _______       30-45    _______      45-60   ______           Over 60   _______

Home Address: __________________ __________________________________________________

City ____________________________________     State____________    Zip___________________

Home Phone: (______)_____________________        Cell: (____)_____________________________

Fax: (______)____________________________

Race/Ethnicity/Disability: African-American/Black   ________        Asian/Pacific Islander     _______ 

Caucasian _______     Hispanic/Latino _______Native American/Indian _______Other _____________

Employer: ___________________________________________________________________________

Title: ___________________________________________________________________________         

Work Address: _______________________________________________________________________

City __________________________________State__________________Zip___________________      

Work Phone:   (_________)__________________  Fax:   (______)___________________________        

Email Address: _______________________________________________________________________

Listed below are ways in which members can participate. We would like to know which activities most interest you either because you have experience and can lend expertise or because you have interest in and would like to develop your skills and knowledge in a particular area of member service.  Rank your interest 1-5: 

1 -indicates no interest, 5 –indicates great interest        

Please indicate if you have a professional skill or practical experience in an area by providing a short explanation [E]

1.      Administration/Management: Helping with the administrative efficiency of the organization 

1   2   3   4   5              E___________________­­­­­­­­­­_______________________________________

2.      Finance: Assisting with specific financial aspects of the nonprofit 

1   2   3   4   5              E___________________­­­­­­­­­­______________________________________

3.      Fund Raising: Assisting with and/or overseeing fund development issues 

1   2   3   4   5              E___________________­­­­­­­­­­______________________________________

4.      Program Focus:  Program research and performance, program literacy

1   2   3   4   5              E___________________­­­­­­­­­­_______________________________________

5.      Legal:  Lending professional knowledge regarding various legal issues 

1   2   3   4   5              E___________________­­­­­­­­­­_______________________________________

6.      Marketing / Public Relations: Assisting with and/or overseeing public relations and marketing management,  assisting staff to insure continuity of printed and electronic messages

1   2   3   4   5              E___________________­­­­­­­­­­_______________________________________

7.      Human Resources: Helping in the areas of personnel management 

1   2   3   4   5              E___________________­­­­­­­­­­_______________________________________
 
8.      Strategic Planning: Nonprofit Planning (including strategic thinking and planning, scenario planning

1   2   3   4   5              E___________________­­­­­­­­­­_______________________________________

9.      Public Policy:  Activism/advocacy for issues relating to domestic violence and sexual assault 

1   2   3   4   5              E___________________­­­­­­­­­­_______________________________________

10.  Technology:  Assisting with and/or overseeing information technology needs 

1   2   3   4   5              E___________________­­­­­­­­­­_______________________________________

Community Connections/Contacts:

Please let us know if you have contacts or connections with individuals in the following professional areas:

Religious organizations                                   

Corporate                                                        

Education                                                        

Media                                                              

Political                                                           

Philanthropy                                                    

Small business                                                 

Social services                                                 

Health                                                             

Legal                                                               

Government                                                    

Other (specify)
                                                                                    

 


                                                                                    


Is there anything else you’d like to tell us to consider?                                                                                                                                                                               _                                            

_____________________________________________________________________________________________________________



Thank you for your interest in Project Unity USA!