Contact Information
Full Name

Personal Email Business Email

Cell Phone Number Business Phone Number

Street Address

City

State Zip Code

Emergency Contact Name Emergency Contact Phone

Demographics
Project Blueprint for diversity, equity and inclusion is a culturally diverse program; therefore, it is necessary for us to collect demographic information for all participants. This information will be used only to ensure alignment with the program's vision and goals.

Age Range 18-2526-3536-4546-55Over 55

Sex MaleFemaleOtherPrefer Not to Respond

Race African-American/BlackAsian-AmericanHispanicNative AmericanCaucasianOther

Race, if Other

Education High SchoolCollegePost CollegeTechnicalOther

Education, if Other

Resume and Skills
Your resume should include your contact information, education and skills and two professional references. Please upload your resume.

Please choose the top five skills you possess in which you believe will be assets in your role as a board or committee member:
Finance/AccountingFundraisingGeneral BusinessHuman ResourcesLegalMarketingProgram DevelopmentPublic RelationsStrategic PlanningTechnologyOther

Other

Community Involvement
Tell us about your community involvement and why you are invested in the community.

Which of the following community issues are important to you. Choose your top five: Adult educationChildren/youthCommunity improvementCrimeDomestic violenceEarly childhood educationFinancial literacyHealth/disabilitiesHousing/homelessnessHungerJob training/employmentImmigrationMental healthSenior servicesSubstance abuse/addiction treatmentVeterans

What are some positive initiatives you see occurring in Stark County which you would like to become more involved with over time?

Help us understand why you want to be involved in Project Blueprint by sharing with us your leadership experiences and aspirations.

How do you see Project Blueprint training assisting you in Board and/or committee settings?

Applicant Commitment
Upon acceptance to United Way’s Project Blueprint, I am expected to respect and honor the opinions and beliefs of others. I am aware that this program utilizes diversity to support nonprofit board inclusion. I am expected to remain professional and mindful of the overall goal and objectives of the program. I am also aware that the program will not tolerate any behaviors such as overt alienation of participants/individuals because of their beliefs, inappropriate forms of communication, and a display of strong emotions, that would interfere with the integrity, mission and objectives of the program. If such behaviors do occur, United Way staff will take corrective action.

I understand the time commitment and the program goals of United Way’s Project Blueprint. If selected, I plan to attend each session during its entirety. I am aware that coming and going throughout the session is not permitted. Should I leave a session for a meeting for longer than 10 minutes or arrive 10 minutes late for a session, I understand that it will be considered an absence. Because the calendar is set well in advance and I have advanced notice, I understand that only an emergency should warrant leaving or arriving late and I must check in with the program director prior to leaving or arriving late.

I understand that if I miss more than 1 session or fail to actively participate, I will not graduate and my participation fee will not be refunded.

I further agree that the information presented herein is accurate and complete to the best of my ability and that no omissions or false statements have been made to justify my participation in the program.

By submitting your application, you are agreeing to the above applicant commitment.