Board Application

You may submit your application online by filling out the online form. If you prefer to mail your application or deliver it to the Foundation office, you may download an application PDF at the link below. Gulfport Senior Center Foundation, 5501 27th Ave S, Gulfport, FL 33707. Office hours: 9:30 – 1, Monday-Friday.

DOWNLOAD APPLICATION PDF

Gulfport Senior Center Foundation Board Member Application

Thank you for your interest in joining the Gulfport Senior Center Foundation Board of Directors.

Board members will serve a term of three (3) years and are eligible for re-election at the end of their term. In their sixth year, board members may apply for an additional two consecutive terms. Board members must possess a current membership in the Foundation. Board members are required to serve on at least one committee and to participate in Foundation events. Committees usually meet monthly, or as Foundation needs require. Please submit your completed application online, if possible, along with a resume or cover letter telling us about you and why you wish to be on the Board.

Name *

Your home phone number:

Your cell phone:

Address *

Apt, suite, etc.

Country

City

State

Zip code

Your email address: *

Briefly describe why you would like to join our Board of Directors: *

Please List Your Current Organizational Affiliations *

Please list the names of organizations and your role (s).

Which Committee (s) Would You Like to Join? *

Budget & Financial Review

Celebration Wall & Veterans Park Brick Project

Grants

Events

Membership

Public Relations

Please check all that apply.

Skill(s) that you would like to utilize? *

What would you like to get for yourself out of your participation on the Board, e.g., what types of experiences, skills to develop, interests to cultivate for you, etc.? *

Board Member Agreement

If you join the Board, you agree to be on at least one committee, that you can provide at least 3-6 hours a month in attendance to Board and Committee meetings, and attend and volunteer at Foundation events as much as possible. You also agree that you do not have any conflict-of-interest in participating on the Board.

By signing this Application Form, you hereby certify as follows:

I hereby certify and affirm that regardless of adjudication, I have not been convicted of, or found guilty of, or pled guilty or nolo contendere to, or been incarcerated within the last 10 years as a result of having previously been convicted of, or found guilty of, or pled guilty or nolo contendere to, any felony within the last 10 years.

I hereby further certify and affirm that regardless of adjudication, I have not been convicted of, or found guilty of, or pled guilty or nolo contendere to, or been incarcerated within the last 10 years as a result of having previously been convicted of, or found guilty of, or pled guilty or nolo contendere to any crime involving fraud, theft, larceny, embezzlement, fraudulent conversion, misappropriation of property, or any crime enumerated in Florida Statutes Sect. 496.405(2)(d)6.

I hereby further certify and affirm that I have not been enjoined in any jurisdiction from soliciting contributions or been found to have engaged in unlawful practices in the solicitation of contributions or administration of charitable assets or been enjoined from violating any law relating to a charitable solicitation.

Signature

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If you are not selected as a member of the Board, or if you decide not to join, would you like to be a volunteer to assist our organization in various ways that match your skills and interests?

Yes

Maybe

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