CICF Board Survey (2024) CICF Board Survey Name: * Name: First Name First Name Last Name Last Name Preferred full name for tent card: Company: * Job title: * Birth date (mm/dd/yyyy) Business address: * Business address: Business address: Business address: City City State/Province State/Province Zip/Postal Zip/Postal Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Business phone: Personal phone: Preferred email: * Home address: Home address: Home address: Home address: City City State/Province State/Province Zip/Postal Zip/Postal Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Assistant’s name: Assistant’s email: Assistant’s phone: Include assistant on all board and/or committee correspondence? Yes No DEMOGRAPHIC INFORMATION All questions in this section are optional. Select the race/ethnicity options with which you mostly closely align. Select all that apply. Asian/Asian American Black/African-American Hispanic/Latinx Multi-Racial Native American/American Indian/Alaska Native Native Hawaiian/Pacific Islander White Prefer not to respond Other (please specify)Other (please specify) Select the following disability characteristics with which you identify. Select all that apply. Intellectual disability Learning disability Neurodivergent Physical disability No disability Prefer not to respond Other (please specify)Other (please specify) If you require special accommodations for board meetings, please describe. Let us know if you would like us to contact you to discuss further. Select the following gender identity with which you identify. Genderfluid Man Non-binary Transgender Woman Prefer not to respond Other (please specify)Other (please specify) What are your preferred pronouns? Select the following sexual orientation with which you identify. LGBTQ+ (please specify) Straight Prefer not to respond Other (please specify)Other (please specify) Select the following religious affiliates with which you identify. Select all that apply. Agnostic Atheist Buddhist Catholic/Roman Catholic Hindu Jewish Mormon Muslim Orthodox (e.g., Greek or Russian Orthodox) Protestant/Christian (not Catholic) Nothing in particular Prefer not to say Other (please specify)Other (please specify) PROFESSION/SKILLS Please select the following professional skills that you may have. Select all that apply. Advocacy/Policy/Government Affairs Business Strategy/Analysis Development Education Entrepreneurship Event Planning Executive Leadership Finance/Financial Management/Accounting Fundraising Governance Human Resources Information Technology Investment/Portfolio Management Legal Marketing/Communications Media/Public Relations Medicine/Health Care Non-Profit Management Opportunity, Equity & Inclusion Public-Private Partnership Real Estate Research Sales Social Enterprise/Impact Investing Social Media Strategic Planning Other (please specfy)Other (please specfy) COMMITTEE AREAS OF INTEREST (This does not automatically volunteer you for a committee; we are in the process of fine-tuning our committees and will provide you with more information about each committee in which you express interest. Please note that it is expected that each Director serve on one or more committees.) Please select the committee areas that may interest you. Select all that apply. Affiliate Development Donor Services & Effective Philanthropy Executive (interest in being considered for future officer role) Finance Governance/Nominating Not-For-Profit Sustainability Planned Giving Regional Leadership Initiatives Strategic Planning GEOGRAPHIC AREAS OF INTEREST Select the following geographic areas in which you have a particular interest. Select all that apply. Marion County Particular Area of Marion County (e.g., Center Township, Pike Township, Speedway, Beech Grove); please specify:Particular Area of Marion County (e.g., Center Township, Pike Township, Speedway, Beech Grove); please specify: Hamilton County Particular Area of Hamilton County (e.g., Fishers, Arcadia, Sheridan, Noblesville); please specify:Particular Area of Hamilton County (e.g., Fishers, Arcadia, Sheridan, Noblesville); please specify: Central Indiana Region (Marion County and the donut counties) Indiana (statewide) No preference PHILANTHROPIC AREAS OF INTEREST Select the following philanthropic areas in which you have interest. Please select no more than 5-10. Animal Welfare Arts & Culture Child Abuse Child Care Civil Rights Community-Led Development Computer Literacy Conservation/Environment Crime Prevention Criminal Justice Reform Cultural Development/Heritage Disability Care Disaster Relief Drug & Alcohol Abuse Domestic Violence Economic Development/Mobility Economic Justice Early Childhood Education Elder Issues New Option Employment Training End of Life Care Faith-Based Services Family Success/Stabilization Financial Literacy Greenways & Trails Health Equity/Access to Quality Healthcare Healthcare Healthy Lifestyles HIV/AIDS Homelessness & Housing Hunger Immigrant & Refugee Issues Infant & Maternal Mortality International Issues K-12 Education Legal Aid/Services LGBTQIA+ Issues Libraries Literacy Marriage & Family Medical Research Mental/Behavioral Health Mission Services Museums Neighborhood Empowerment & Placemaking Opportunity, Equity & Inclusion Parenting Parks & Greenspace Peace/Conflict Resolution Performing Arts Philanthropy & Volunteerism Poverty Public Art Racial Equity/Dismantling Systemic Racism Religion Religious Freedom Reproductive Rights Scholarships Science & Technology Self-Sufficiency Spiritual Development Sports & Recreation Women’s & Girls’ Issues Youth Development Other (please specify)Other (please specify) PHILANTHROPIC COLLABORATIVE FUNDS & OPTIONS For my own individual, family, or corporate philanthropy, I am interested in learning more about (optional): Select all that apply. Unrestricted Giving: giving to the area of greatest need via The Indianapolis Foundation’s and/or Hamilton County Community Foundation’s unrestricted endowment funds. Currently being matched 2(LEI):1(Donor) by the Lilly Endowment’s GIFT Initiative Donor-Advised Fund: create a DAF to organize your philanthropy and make grants to the organizations and causes you care about with the assistance of our Effective Philanthropy Team Corporate-Advised Fund: create a corporate donor-advised fund to organize your business’ philanthropy and engage employees with the assistance of our Effective Philanthropy Team Planned Giving: create a fund to establish your philanthropic legacy in perpetuity as part of your estate plan through a gift in your will, beneficiary designation, charitable gift annuity, or charitable trust Scholarship Fund: create a fund to benefit students pursuing post-secondary education (2- or 4- year degree programs; trade, technical or vocational school; graduate school; etc.) IMPACT Account: create a fund through which you can make loans and equity investments (i.e., impact investments) to social enterprises, including for-profit organizations with a charitable purpose Initiative Giving: give to The Indianapolis Foundation’s and/or Hamilton County Community Foundation’s specific initiatives that align with your areas of interest. Some areas are being matched 1:1 by the Lilly Endowment’s GIFT Initiative I already have one or more funds with the Philanthropic Collaborative. I have already included one or more entities at the Philanthropic Collaborative in my estate plan. Submit