Diversity Roundtable "Willingness to Serve" Survey

The Diversity Roundtable [DRT] grew from the Vision 2020 Plan for the Future, created by the Lafayette/West Lafayette community in 2001. The DRT’s vision is “A Community that Values Diversity.” To achieve this vision, three arenas have been identified for priority action: Leadership, Education, and Awareness.

In an effort to expand and diversify the pool of emerging community leaders, the Leadership committee of the DRT has created a “willingness to serve database” of individuals interested in serving their community as appointed members of non-profit boards, government commissions, and other community leadership positions. Organizations only work through the involvement of people, and we want to assure that all people have opportunities to lead in Tippecanoe County. To be included in the database, please complete the survey below. Your information will be placed in a database housed at Greater Lafayette Commerce. The information will be available for board and commissions as vacancies open.

Name:

Address:

City:

Zip Code:

Home Phone:

Work Phone:

Cell Phone:

Email Address:

Areas of Interest (check as many as apply):

Neighborhood Development

Education

Creating Art

Small Business

Long Range Planning

Other Areas of Interest

Fund Raising

Music

Children

Religion

Poverty

Latino Culture/Affairs

Event Planning

Workforce Training

Cultural Celebrations

Mentoring

Diversity

Work or Community Service Experience:

Please share your work or community service related experience that you believe will help you serve on a non-profit board or a government commission.

References:

Please share names and contact information of individuals who would be willing to support your appointment to a non-profit board or commission.

How would you add to the diversity of a board or commission?:

Are you willing for your name to be placed in a database?:

Yes

No

Your name and information will be made available to local non-profit agencies or government officials for possible appointment to a board or commission.

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