Board Member Candidate Form

2026 Board Member Candidate Interest Form

To be considered for serving on the MPI-CC Board of Directors for the 2026 term, you must complete and submit this form by 5 p.m. EDT May 30, 2025.

Please review the Leadership Manual and Principles of Professionalism before submitting this form.

Name

Employer

Job Title

Address

City

State

Zipcode

Phone Number

How long have you been a member of MPI?

Board Positions

Please indicate up to three positions you are interested in. A complete listing of the position descriptions can be found in the Leadership Manual.

First Choice

Second Choice

Third Choice

If not nominated to serve in your position of choice, would you serve in another board position?

Yes

Professional Experience

List your most meaningful awards, certifications, or other professional recognition received during your career.

List any allied professional organizations or civic roles that you actively support. How will these affiliations foster your service as an MPI-CC leader?

MPI Involvement & Understanding

List your past involvement in MPI (including other chapters or at the Global level), such as task force, committee participation, and board positions. Include your years of involvement in each position.

Are you currently an active volunteer in MPI-CC and if so what is your role/project?

What do you see as the most important issue or concern facing MPI-CC during the next three years and why?

Personal Qualifications and Leadership

What skills and experiences do you identify as your strengths? How would you apply these strengths and experiences as a member of the MPI-CC Board of Directors to advance our chapter?

How would other chapter volunteers and/or your co-workers describe your leadership style?

Have you had experience creating and/or working with a budget? Please describe.

Describe how you have incorporated teamwork and mentoring into your membership at MPI-CC or in your professional or volunteer roles.

Describe rewards and challenges you have faced in a past leadership role.

Diversity, Equity and Inclusion

MPI-CC is committed to embracing and fostering an environment that respects all individuals regardless of national origin, race, religion, sex, gender identity, gender expression, age, color, sexual orientation or disability. As part of this commitment, we encourage our members to actively participate in our shared journey of learning, growth and connection.

The challenges surrounding Diversity, Equity and Inclusion are complex and ever-evolving. Based on your understanding and experiences, what do you think is the most pressing DEI challenge facing our industry/chapter today? How would you propose we address this challenge as a chapter?

Diversity, Equity and Inclusion values are critical in fostering an inclusive environment where all members feel valued and respected. Please share an example of how you have personally or professionally committed to these values. How do you envision promoting these values as part of our board to benefit our chapter?

Statement of Commitment and Consent

If nominated and elected, I agree to actively serve on the MPI-Carolinas Chapter Board of Directors, to be objective in my considerations of policy issues, and to represent the best interest of the entire membership at all times.
I have the full support of my employer in regard to the duties and responsibilities of the position I am seeking.
I have reviewed the Leadership Manual and agree to abide by the Annual Pledge of Commitment (p. 43-44) and the Leadership Promise (p. 45-46).
I agree to attend and fully participate in all board meetings to the best of my ability; to arrive for board meetings fully briefed and prepared on the issues to be discussed; to promote the programs, goals and projects of MPI and the Carolinas Chapter; and to faithfully discharge the duties that are assigned to me by the board.
I understand that a member of the Governance and Nominating Committee will contact me to discuss my candidacy.

I agree to the terms listed under Statement of Commitment and Consent.

Yes

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