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Keep Nebraska Beautiful Board of Directors Application Form

Personal Information

Full Name(Required)

First Last

Address

Street Address Address Line 2 City State ZIP Code

Email(Required)

Phone

Employer Information

Employer Name(Required)

Employer Name

Your Title(Required)

Your Title

employer address(Required)

Employer Address Address Line 2 City State ZIP Code

Business Email(Required)

Business Phone

Type of business or organization:(Required)

Primary service(s) and area/population served:(Required)

Preferred method of contact:(Required)

History & Skills

Please list boards and committees that you serve on, or have served on:

e.g. business, civic, community, fraternal political professional recreational religious, social. Click on the "+" button to add more lines.

Organization

Role/Title

Dates of Service

Education/Training/Certificates

Optional: Have you received any awards or honors that you'd like to mention?

How do you feel Keep Nebraska Beautiful would benefit from your involvement on the Board?

Skills, experience and interests(Required)

Please check all that apply

Finance, accounting

Nonprofit Experience

Program Evaluation

Special Events

Outreach, advocacy

Personnel, Human Resources

Community service

Public relations, communications

Grant writing

Administration, management

Policy development

Education, instruction

Fundraising

Other

If "other" was selected, please specify:

Please list any groups, organizations or businesses that you could serve as a liaison to on behalf of [name of org].

Anything else you would like us to know?

Consent(Required)

If selected to be a member of the Board, you agree that you can provide at least 2 hours a
month in attendance to Board and Committee meetings, and that you do not have any
conflict of interest in participating on the Board. Additionally, Board Members are expected
to join Keep Nebraska Beautiful with a $100.00 membership to support the organization's
mission and operations.

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.(Required)

Full Name(Required)

First Last

KNB Board Appliation

Personal Information

Full Name(Required)

First Last

Address

Street Address Address Line 2 City State ZIP Code

Email(Required)

Phone

Employer Information

Employer Name(Required)

Employer Name

Your Title(Required)

Your Title

employer address(Required)

Employer Address Address Line 2 City State ZIP Code

Business Email(Required)

Business Phone

Type of business or organization:(Required)

Primary service(s) and area/population served:(Required)

Preferred method of contact:(Required)

History & Skills

Please list boards and committees that you serve on, or have served on:

e.g. business, civic, community, fraternal political professional recreational religious, social. Click on the “+” button to add more lines.

Organization

Role/Title

Dates of Service

Education/Training/Certificates

Optional: Have you received any awards or honors that you'd like to mention?

How do you feel Keep Nebraska Beautiful would benefit from your involvement on the Board?

Skills, experience and interests(Required)

Please check all that apply

Finance, accounting

Nonprofit Experience

Program Evaluation

Special Events

Outreach, advocacy

Personnel, Human Resources

Community service

Public relations, communications

Grant writing

Administration, management

Policy development

Education, instruction

Fundraising

Other

If "other" was selected, please specify:

Please list any groups, organizations or businesses that you could serve as a liaison to on behalf of [name of org].

Anything else you would like us to know?

Consent(Required)

If selected to be a member of the Board, you agree that you can provide at least 2 hours a
month in attendance to Board and Committee meetings, and that you do not have any
conflict of interest in participating on the Board. Additionally, Board Members are expected
to join Keep Nebraska Beautiful with a $100.00 membership to support the organization’s
mission and operations.

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.(Required)

Full Name(Required)

First Last

Keep Nebraska Beautiful
8101 O Street, Suite 114
Lincoln NE 68510
(402) 486-4562

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Keep Nebraska Beautiful Board of Directors Application Form

Personal Information

Employer Information

History & Skills

KNB Board Appliation

Personal Information

Employer Information

History & Skills

Contact Us