Board of Directors NOMINATIONS/APPLICATION FORM As a representative of a GIA member organization, you are invited to nominate yourself or another individual who you think has the time, talents and commitment to guide GIA’s strategy and development as a member of its board of directors. Under GIA policy, the Board is responsible for overall policy and direction of GIA, and delegate’s responsibility for day-to-day operations to the Executive Director and committees. The Board receives no compensation. Each Director of GIA shall be employed by or be a member of the Board of Directors or trustees of a member institution or grantmaking foundation of GIA. If you are nominating an individual, please be sure to talk with the individual first to ascertain interest and willingness to comply with the responsibilities and expectations of GIA board members spelled out in the accompanying material. (Only electronic submissions will be accepted; please do not mail or fax.) To be considered, please email this form and a short resume to:jfeather@giaging.org Name of Nominee/Applicant: Title: Organization Affiliation: Mailing Address: Phone: Fax: Email: Nominator, if applicable (name/ affiliation): 1. Commitment GIA expects that all nominees and applicants understand the commitments involved in serving on the GIA Board of Directors. Please review our “Directors’ Roles and Responsibilities” document for more details or contact GIA staff with questions about these expectations. Does the nominee—or do you as the applicant—understand these commitments and plan to meet them as a board member, particularly around time commitment and fund-raising responsibilities? 1 GIA Board of Directors Nominations Form 2. GIA Involvement What GIA activities has the nominee—or you as the applicant—been engaged in? How has this experience been good preparation for a leadership role on GIA’s board? 3. Leadership in the Field Beyond the GIA activities described in the previous question, has the nominee—or you as the applicant— been engaged in other activities to strengthen the field of aging philanthropy? If so, please describe. 4. Board Experience What experience has the nominee—or you as the applicant—had with other boards of directors? Please describe specific contributions you have made through any past board service or working directly for other boards? 5. Interest in GIA Why is the nominee—or you as the applicant—interested in serving on GIA’s board? Any specific ideas for how GIA can improve its efforts and activities to strengthen aging philanthropy? 6. Philanthropic Emphasis What issue areas are emphasized in the nominee’s work—or your work as the applicant—in aging philanthropy? Any particular issues of interest, passion or knowledge (both at the individual and foundation levels)? What sorts of organizations are funded and in what areas of the country? Any special focus on age or population or leverage points in promoting healthy aging, independence, intergenerational programs, the arts, and/or geriatric care? 7. Skills & Knowledge Please indicate which areas of expertise the nominee or applicant can offer the GIA board Development/Fund Raising Public Sector/Government Finance/Accounting Communications, Public Relations, Marketing Leadership/Governance Social Media Legal Issues Research/Evaluation/Learning Membership Organizations Outreach to Minority, Low-Income and/or Public Policy/Advocacy Rural Communities Please suggest how the nominee—or you—might use these skills as a board member. 2 GIA Board of Directors Nominations 8. Demographics & Primary Position Grantmakers In Aging values diversity of background, skills, perspectives, cultures and personal attributes. Completion of the following sections is optional but will assist the Governance Committee in its efforts to ensure that GIA’s Board reflects the demographics of our membership. Age Range: <50 50+ Gender: Female Male Transgender Race/Ethnicity: American Indian or Alaska Native Asian Black or African American Hispanic, Latino or Spanish origin Native Hawaiian or Other Pacific Islander White Misc: Disability Lesbian, Gay or Bisexual Foundation Type: Community Corporate Family Operating Private/Independent Public Charity Primary Position: Employee Individual Philanthropist Trustee Location: Northeast South Midwest Mountain Pacific 9. Strong Connections (For each selection, please provide example of connection.) Business/Corporation Civic Groups Educational Institutions Executive/Legislative Branches Government Agencies/Public Sector Minority, Low-Income and/or Rural Communities/Organizations National/State/Local Networks Philanthropy/Foundations Other 3 GIA Board of Directors Nominations Form 10. Perspective GIA strives to bring a diversity of perspectives to its board (including personal, philosophical and professional). Describe the most important influences on the perspectives the nominee—or you as the applicant—bring to aging philanthropy. How would those perspectives make a significant contribution to the board’s leadership and work? 11. Questions Does the nominee—or do you as the applicant—have any questions about Grantmakers In Aging? 4 GIA Board of Directors Nominations Form