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Thank you for your interest in Flourish Agenda. Please complete the form below for Board Member consideration.

Please complete a Contact Us form for any questions about board service.

Contact Information

Name(Required)

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Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Preferred Email Address(Required)

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Preferred Phone Number(Required)

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Additional Information

Please identify your racial, ethnic and/or cultural background, if comfortable. Flourish Agenda uses this information to gauge its effectiveness in recruiting a diverse group of members.

African American

Native American/Alaska Native

Hispanic/Latina/Latino

Asian American

Pacific Islander/Native Hawaiian

White/Caucasian

African

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More Than One Race

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Other

Gender Identity

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Genderqueer/Gender Non-Confirming

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How did you learn about Flourish Agenda?

Website/Google Search

Colleague or Friend

Event/Training/Conference

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Current or Past CLient

Other

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Affiliated with a Company?

Yes

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Skills and Interests

Do you have experience serving on a nonprofit board?(Required)

Yes

What other boards have you served on?

Professional Skills and Experience that you will bring to board service opportunities. (Check all that apply)(Required)

Have you participated in training/education about the roles and responsibilities of a nonprofit board member?(Required)

Yes, through my employer

Yes, through a nonprofit board

Yes, through another educational opportunity

In a couple of sentences, why are you interested in joining the Flourish Agenda board?(Required)

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1714 Franklin St, Ste 100-321
Oakland, CA 94612

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Application toJoin the Board

Contact Information

Additional Information

Skills and Interests

Application to
Join the Board