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Burkellyn Foundation

Board of Directors Application


Important Information
Thank you for taking the time to fill out this application. We appreciate all applicants. Please note that the
selective process is not easy for us and we hope to see you on the team. All positions for the foundation
are important and require varying numbers of hours worked each month. Please note the foundation is
currently not 501c3 cleared, therefore donations will not be made directly to and from the foundation at
this time. Upon the establishment of a board; the foundation will soon follow. Payment will not be
consistent nor will it be guaranteed for all members on the board. Payment will be a direct result of
personal hours worked on Foundation projects, meetings, and outside work to benefit our goals and
bylaws. All hours should be logged and given to the President, Vice President, or Secretary. Please fill
out the application to the best of your knowledge. Upon completion of this application, you may follow the
steps at the bottom of page 3.

Contact Information
Full Legal Name
Street Address
City
State
Zip Code
Primary Phone
Primary E-Mail

Interests (optional)
Please choose 3 position interesting to you (marking them 1 being your first choice). Keep in mind that
some may be taken and you may be assigned a different roll based on the information provided in this
application. (For full job descriptions, see below)
___ Vice President
___ Secretary
___ Public Relations
___ Committee Chair
___ Board Member

Special Skills or Qualifications


Summarize special skills and qualifications you have acquired from employment or previous volunteer
work such as, Grant Writing, Committee work, Fund Raising, etc.

Current Employment (if you are currently unemployed leave this selection blank)
Current employer:
Employer address:
Phone:
City:
Position:
May we contact this employer?

How long?
E-mail:

Fax:
State:
ZIP Code:
Average hours worked per week:

Agreement and Signature


By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that
if I am accepted onto the Board of Directors, any false statements, omissions, or other misrepresentations
made by me on this application may result in my immediate termination. I also affirm that I must be
available once a month for Board Meetings for the foundation. I also agree to uphold my responsibilities
for the position given to me via my application.
Name
Date

M___/D____/Y_______

Our Policy
It is the policy of this Foundation and its staff, to provide equal opportunities without regard to race,
colour, religion, national origin, gender, sexual preference, age, or disability.
Please note: Meetings for the foundation will be held once a month minimal for legal reason. If you
cannot make these regular meetings your involvement with the foundation will be terminated. Meetings
will be planned in advanced and we will work around individuals. Failure to notify your absence or
availability can result in immediate replacement and termination with no exception. Meetings will be
scheduled 30 days in advanced by a group consensus. E-mail reminders will be sent out to all staff and
board members. Phone calls, text messages or any other form of communication via social media is
optional upon request.

Thank you for completing this application form and for your interest in joining our cause.

Sending Application
Once the application is completed to the best of your ability, you may e-mail the completed document to
the e-mail below. If you do not have an e-mail; printing and mailing instructions are listed below.
E-mail to: burkellyn@gmail.com
Mailing Instructions:
1. Print Pages 1 and 2
2. Sign signature on line below in pen
3. Put in envelope and mail to the following address:

P.O. Box 954 Onalaska WA 98570

Signature. _______________________________________________________

Foundation Job Descriptions


Vice President:
This position is typically the successor to the Presidents position.
Performs Presidential responsibilities when the President cannot be available
Reports to the Board President
Works closely with the President and other staff
Participates closely with the President to develop and implement officer transition plans.
Performs other responsibilities as assigned by the board and President.

Secretary
Maintains records of the board and ensures effective management of Foundation's records
Manages minutes (notes) of ALL Foundation/board meetings and events
Ensures minutes are remembered and called upon in future meetings
Is sufficiently familiar with legal documents (articles, by-laws, IRS letters, etc.) to note
applicability during meetings

Committee Chair
Is a member of the board
Sets tone for the committee work.
Ensures that members have the information needed to do their jobs.
Oversees the logistics of committee's operations.
Reports to the Board President.
Reports to the full board on committee's decisions/recommendations.
Puts together and evaluates a committee by setting the agenda and holding meeting

Public Relations
Maintains good relationships with the public and makes press appearances on behalf of the
foundation
Listens to concerns from the public and addresses them to the board during meetings

Board Member
Regularly attends board meetings and important related meetings.
Makes serious commitment to participate actively in committee work.
Volunteers for and willingly accepts assignments and completes them thoroughly and on time.
Stays informed about committee matters, prepares themselves well for meetings, and reviews
and comments on minutes and reports.
Gets to know other committee members and builds a collegial working relationship that
contributes to reach a board consensus.
Is an active participant in the committee's evaluation and planning efforts
Participates in fund raising for the Foundation (nonprofit only)