Please indicate which BVU services your organization is seeking (check all that apply): Please indicate which BVU services your organization is seeking (check all that apply): Referral of board members Referral of volunteer consultants for operational issues Referral of direct services volunteers Training/development for board Succession Planning Strategic Planning Do not know Other

Your Name:

Your Title:

Your Email:

Organization Name:

Date Established:

Address:

City:

State

Zip Code:

Phone Number:

Web Address:

Number of paid full-time staff or (FTE):

Organization Annual Budget:

Please describe your organization's mission and services:

Please check all that apply in relation to your organization's mission and services: Please check all that apply in relation to your organization's mission and services: Arts, Culture & Humanities Cultural Disease Education Environment/ Animals Health Issues Human/ Social Services Other Religion

Is there anything else that you would like us to know about your organization or your organization's board?