Thank you for your interest in exploring Leaders on Board for your nonprofit organization. Since January 2009, Leaders on Board has successfully matched more than 800 individuals with more than 160 nonprofit organizations. These individuals are committed and passionate about issues that affect our communities like domestic violence, education and health advocacy

Your nonprofit can have access to more than 900 Leaders on Board participants who have been trained in the basics of board membership and who have expressed an interest in serving on a nonprofit board. Each participant has a completed profile that helps us connect them to the right nonprofit organizations through an Express Match or through an individual referral.

To receive individual referrals to our program participants, nonprofits must complete the following steps:

Apply for the program
Provide a copy of the bylaws
Provide a copy of the latest financial statement given to the Board of Directors
Provide a copy of the required Directors and Officers Liability Insurance
Provide a copy of the latest 990 (IRS Form)
Provide a list of your current Board of Directors (as listed on the registration)
Once invoiced, pay the fee

Please email materials to Mae Maloney at mae.maloney@leadershipgh.org.

Once all the paperwork has been submitted and processed by our Program Director, your nonprofit begins enjoying the benefits available to our nonprofit partners.

Leaders On Board – Nonprofit Application

Agency Name:
Address:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Contact Name:
First Last
Title:
Email
Phone:
Company Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Website:
Organization’s Mission:
Describe your primary group and/or services:
Board member responsibilities:
Describe the current process for Board Member application, selection and orientation:
Year Incorporated:
Annual Budget:
Number of Paid Staff:
Number of Volunteer Staff:
Number of Volunteer Staff:
Current Board Size:
Max Board size according to bylaws:
Board Terms:

(Length, staggered, etc.)
Expected financial contribution from Board Members:
Date/Time of Board Meetings:
Location:
List of committees:
Directors & Officers Liability Insurance Provider:

We agree to carry Nonprofit Directors and Officers Liability Insurance throughout the duration of our partnership with Leadership Greater Hartford’s Leaders on Board program.
Please email a copy of the declarations page to mae.maloney@leadershipgh.org.
Signature
Primary Group Served:
List skills, characteristics & competencies sought in new Board Members:
All Requirements:
- D&O Insurance
- 990
- BOD List
- Financial Statement
- Application
- Dues
All materials can be uploaded and submitted using the following Google Form: https://docs.google.com/forms/d/e/1FAIpQLSdJOKgxhK1v624HIw7YBv2_MJVYlYbL-OYKLgeebdq9pX_mGA/viewform. Please email Senior Program Director, Mae. Maloney at mae.maloney@leadershipgh.org with any questions.

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