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Please enter a first name

First Name *

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Prefix Amb. Chief Col. Dep. Dr. Gen. Gov. Hon. Judge Justice Lt. Min. Mr. Mrs. Ms. Pastor Prof. Rep. Rev. Rev. Dr. Sen. Sgt. Sir Other

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Educational Level *:

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Educational Level (Check all that apply) * High School Associate Bachelor's Master's Doctorate Other

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Skills/Competencies relevant to nonprofit management * Marketing Finance Technology Strategic Planning Writing Research Project Management Government/Community Relations Fundraising Grant Writing Other

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Employment Status * Employed Full-time Employed Part-time Self-Employed Retired Student Other

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Industry Categories *:

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Industry Categories * Technology Manufacturing Healthcare Higher Education Not for Profit Government Financial/Banking Insurance Other

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Age Range * Under 24 25 - 34 35 - 44 45 - 54 55 - 64 65+

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Chapter Information

What is Your Chapter? * Anne Arundel Baltimore Metropolitan Bergen/Passaic Birmingham Metropolitan Central Alabama Central Mississippi Central New Jersey Central Ohio Chattanooga Chicago Metropolitan Columbia, SC Dallas Metropolitan Decatur DeKalb Delaware Fort Worth Metropolitan Greater Austin Greater Cleveland Greater Huntsville Area Greater Jacksonville Greater Knoxville Greater New Orleans Greater Savannah Greater Seattle Washington Harrisburg Houston Metropolitan Indianapolis Las Vegas Long Island Los Angeles Manhattan MECCA Memphis Metro Nashville Metropolitan Atlanta Metropolitan Baton Rouge Metropolitan St. Louis Metropolitan Washington DC New Haven Metropolitan Northern Virginia Northwest Georgia Oakland Bay Area Orange County Pennsylvania Pensacola Phoenix Metropolitian Polk County Prince George's County Prince William County Queen City Metropolitan Richmond Metropolitan Sacramento San Antonio San Francisco Silicon Valley South Bend Area South Palm Beach County Southern Maryland Southern New Jersey Southwest Mississippi Stone Mountain-Lithonia Suffolk County Tampa Bay Area West Palm Beach Other

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Past Leadership - Chapter *:

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Past Leadership - Chapter * Chapter Board Member Chapter President Chapter 1st VP Chapter 2nd VP Chapter 3rd VP Chapter Secretary Chapter Treasurer Chapter Financial Secretary Chapter Officer (Other) Chapter Committee Chair N/A

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Past Leadership - NTL *:

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Past Leadership - NTL * National Board Member National President National 1st VP National 2nd VP National 3rd VP National Treasurer National Secretary National Financial Secretary National Committee Chair National Committee Member National Officer (Other) N/A

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What is your current chapter office? President 1st VP 2nd VP 3rd VP Financial Secretary Corresponding Secretary Recording Secretary Treasurer Member

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NCBW Committees *:

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What committees are you interested in? * Auditing Committee Bylaws Committee Chapter Development Committee (NTL Only) Corporate Operations Committee (National Only) Economic Empowerment Committee Education Committee Ethics Committee Finance Committee Fund Development Committee Health Committee Leadership Development Committee Membership Committee Nominating Committee Policies and Procedures Committee Protocol Committee Public Policy Committee Ritual Committee (Optional for Chapters) Standards Committee Technology Committee

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NCBW Interests/Passions * Health Education/Mentoring Economic Empowerment Advocacy/Legislative/Voting Fund Raising Chapter Development Leadership Training Membership Recruitment Marketing/PR Technology Other

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NCBW Interests/Passions *

Health *

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Health *

Education/Mentoring *

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Education/Mentoring *

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Fund Raising *

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Fund Raising *

Chapter Development *

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Chapter Development *

Leadership Training *

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Leadership Training *

Membership Recruitment *

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Technology *

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Technology *

Other * Other

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Other *

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Networking and Personal Interest *:

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Networking and Personal Interest * Arts, Culture & Media Career/Mentoring Caregiving Entrepreneurship/Business Support Health & Wellness Media & Storytelling Motherhood NCBW Leadership Political Office Social/ Sisterhood STEM & Coding Youth Engagement Other

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Other InformationElected or Appointed Official (current or former)Board Experience - Corporate (current or past)Board Experience - Not for ProfitMilitary VeteranPublished AuthorAwards/Recognition - InternationalAwards/Recognition - NationalAwards/Recognition - Regional/StateAwards/Recognition - Local CommunityN/A

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