Board member self assessment questionnaire
The following is a short questionnaire to facilitate feedback on your own role on the board of this
organization. However, you should feel free to communicate any further thoughts to the board of
the chair in any way you wish.
This questionnaire should be returned directly to the board chair. All responses will be treated as
strictly confidential. No one else will be permitted to see it nor will others be told what you have
said.
1. I believe my strengths as a board member over the past year have been:
2. Areas where I have not been effective as I would wish are:
3. When my current term of office is completed, I would be interested in serving an additional
term (assuming you have not completed the maximum number of terms). YES/NO
4. If ‘no’ please indicate your reasons for wishing to withdraw:
5. Would you be willing to be an officer of the board (chair, vice-chair, treasurer, etc) or head a
board committee? Yes/no
If yes: what types of responsibilities would you be willing to undertake?
6. I have attended approximately __% of board meetings. Insofar as I have had to miss board
meetings, the reason for this have been:
7. I prepare for board meetings by reading background materials and thinking about issues
requiring decisions:
__Always, __often, __sometimes, __seldom, __never
8. At board meetings I feel comfortable discussing issues, and believe that my contributions are
of value:
__Always, __often, __sometimes, __seldom, __never
9. In addition to my participation in board meetings, I have attempted to assist in the following
ways. Please mention any activities undertaken as part of a committee or in an officer
position and any less formal kinds of assistance you have provided (ig. Off the record advice,
useful contacts, etc)
10. I feel my knowledge and understanding of how the board and organization works is:
__yes, __no
If NO, what further orientation or development would you like to receive?
Please add any other thoughts or concerns you may have about the board and/or your role in it.