Social Venture Consulting Application Supplement

If your nonprofit is located in Massachusetts and would like to be considered for Net Impact Boston's Board Fellows Program, please fill out this supplement in addition to the Social Venture Consulting application.

Organization name: *

How many directors serve on your board?: *

Please identify the dates and location of board meetings (2009-2010):: *

What are the committees which make up the Board?: *

Please identify under which committee the Board Fellow's project(s) or iniative(s) would fall.

Given the project described, what skills or experiences are most important to your organization in a Board Fellow?: *

Does your organization havea board member who can serve as a mentor for the Board Fellow?: *

Yes

Please specify the contact information for the board mentor

Board Mentor First Name:

Board Mentor Last Name:

Title or committee on Board:

Email:

Phone:

Are there any special circumstances facing your organization or board? If so, please describe.:

For example, new executive director, significant changes in funding, merger, etc.

Does your organization have any current affiliation with Net Impact Boston or other related organizations?:

i.e. relationships or past projects with other Net Impact chapters of Board Fellow programs.

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