New Candidate For Board Of Directors Self-Evaluation Form

This form is designed to assist The Council’s Nominating Committee in evaluating candidates for a seat on the Board of Directors. In assessing candidates, the Nominating Committee seeks to bring balance and diversity to the Board. Thus, it must consider a candidate’s background to identify areas of special expertise, talents and leadership qualities that will strengthen the Board and its decision-making capabilities.

Name*
Your first name… Your last name…
Nominee Title*
Nominee Firm*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Are you an Owner?*
- Yes
- No
Do your revenues currently meet or exceed the $10 million minimum membership revenue requirement?*
(Required for Board membership)
- Yes
- No
What is your role in your organization?*
Why would you like to serve on The Council’s Board?*
Are you prepared to attend three Board meetings each year and fully participate in the work of one of the three Board committees?*
- Yes
- No
In your view, what distinguishes The Council from other insurance producer trade associations?*
What is the greatest benefit of Council membership to your firm?*
Do you read Leader’s Edge and other publications produced by The Council?*
If elected, what would you like to see accomplished by The Council over the next three years during your term on the Board?*
Please list other insurance organizations to which you belong and your role in them:*
Please list any industry awards, designations or major accomplishments:*
What memberships do you have in other business, fraternal or civic organizations?*
Email
This field is for validation purposes and should be left unchanged.