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Board Member Application

Pope Memorial Humane Society

Statement of Interest/Application for Board or Committee Service

*Please be sure to review our Board Member Roles, Expectations & Committee Information before submitting this form.

Applicant Information

Name(Required)

First Last

Current Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Cell Phone

Email Address(Required)

Work Email

Employment Information (if applicable)

Current Employer

Title

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Consent(Required)

I certify all information on this application is true and correct to the best of my knowledge.

Additional Questions

Please indicate the area of the organization in which you would like to participate(Required)

*if you are interested in joining the board, please indicate a minimum of two committees you would like to be on)

Committees(Required)

Audit

Board Development

Budget and Finance

Capital Campaign

Humane Education

Marketing

Staff Development

Do you know and understand the PMHS Mission?(Required)

Yes

No

If yes, please describe what part of our mission resonates most with you.(Required)

Are you presently a volunteer and/or financial supporter of PMHS?(Required)

Yes

No

If yes, please list how you currently support the shelter.(Required)

Are you or have you ever been a member/supporter of other non-profits?(Required)

Yes

No

If yes, please list organizations and if you have held a position on the board.(Required)

What unique skills and/or talents could the shelter benefit from that you would bring to the board?(Required)

What do you feel are common or perceived strengths of animal shelters?(Required)

What do you feel are common or perceived weaknesses of animal shelters?(Required)

What do you perceive as some of the greatest challenges facing non-profits?(Required)

Based on experiences you have had serving on boards and/or committees, what aspects have made that experience successful for you?(Required)

How much time do you feel you could commit to Pope Memorial Humane Society on a monthly basis?(Required)

(Refer to Board Member Expectations & Committee Information)

There is a minimum financial requirement for all board members of $1,000 per year. Do you have any concerns with fulfilling this obligation?(Required)

Fund-raising for general operations and special projects is an ongoing and crucial part of the viability of any non-profit. Do you have experience in fundraising of which you have personally been involved in, and if yes, would you be willing to share a find-raising success story that you have personally been a part of?(Required)

Why are you interested in becoming a mmeber of the Board for PMHS and why should we select you?(Required)

Additional Comments

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Contact Us

Pope Memorial Humane Society
221 County Farm Road,
Dover, NH 03820

(603) 749-5322

[email protected]

EIN#: 22-2561784

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First Last

Email*

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Hours

PMHS-CV Adoption Center:

Wednesday & Thursday: Open 12-4 PM

Friday & Saturday: Open 12-5 PM

Additional times by appointment

Animal Surrenders:
Appointment Only

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