BOLD Application

Applicant Information

Name*

First Last

Preferred Name

Pronouns

Mailing Address*

Street Address Suite/Apt City State Zip Code

Home Phone

Cell Phone*

Email*

Employer

Brief Job Description (Include title, role, and responsibilities)

Career Focus or Industry

Number of years of experience within career

How did you hear about BOLD?

Social media, colleague, email, etc.

Emergency Contact Information

Name*

First Last

Contact Phone*

Relation to Emergency Contact*

Identity (Optional)

We collect data to understand our applicant population better and evaluate program diversity. Confidentiality and anonymity in reference to identity categories will be maintained.

Age

Ability Status

Do you consider yourself to be a person with a disability or other debilitating chronic condition?

Do you have any access or modification requirements you would like me to be aware of?

If you selected "yes" above, please specify the access or modification requirements you have.

I identify my gender as...

Man
Woman
Nonbinary

I identify my race or ethnicity (select all that apply) as...

American Indian or Alaskan Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian or Other Pacific Islander
White
Other race and ethnicity

Employer or Sponsoring Organization

BOLD tuition is $250 and covers training & materials. Financial assistance available upon request. Many employers and organizations recognize the importance of investing in development programs such as BOLD to sustain and support nonprofit organizations and positively impact our community. Please complete the billing information if your employer or another sponsoring organization will cover your tuition fees.

Employer or Sponsoring Organization Name

Billing Contact Name

First Last

Billing Address

Street Address Suite City State Zip Code

Billing Contact Phone

Billing Contact Email

Application Questions

Professional Networks, Nonprofit Organizations, or Community Activities

List in order of importance to you, up to five community, civic, professional, religious, social, athletic, or other activities and organizations that you are or have been affiliated.

1.

2.

3.

4.

5.

What major accomplishments either in work, military or volunteer service are you most proud of?*

Tell us why you want to participate in BOLD. What are your goals for enrolling in BOLD, and how do you think the program will influence your ability to serve as a leader or board member?*

Tell us about your commitment to community. Identify a cause or issue that you care deeply about and share how you've advocated for it or how you hope to make an impact in the future. In what other ways do you believe you can make a difference in the community?*

Tell us about your volunteer service. What motivates you to serve on a board? What diverse skills, experience, or perspective do you feel you can contribute to a board position?*

Any additional information you'd like to share?

Want to submit any supplementary materials (portfolio, resume?) Upload them here!

Drop files here or

Accepted file types: pdf, jpg, gif, png, docx, doc, Max. file size: 50 MB.

Note: Nothing is required.

References

Please fill out the reference sheet, which can be found at uweci.org/boldref. Applicants should submit at least one reference.

NAACP & UWECI Scholarship Questions (Optional)

To apply for the NAACP & UWECI scholarship (4 total available) Please answer the following questions: How are your background and life experiences connected to diverse communities in East Central Iowa? Why is volunteer leadership important to you in addressing this need?

Statement of Understanding

Please check the following*

I understand that my attendance and participation in BOLD is necessary for the graduation of the program and enrollment into nonprofit board service. I understand that my failure to attend the minimum number of training sessions could lead to removal from the program. Minimum attendance is attending the orientation session, 5 out of 6 sessions, and graduation.

Name*

First Last

Date*

Applicant Information

Emergency Contact Information

Identity (Optional)

Employer or Sponsoring Organization

Application Questions

Professional Networks, Nonprofit Organizations, or Community Activities

References

NAACP & UWECI Scholarship Questions (Optional)

Statement of Understanding

Applicants: