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Demographics

First Name

Last Name

Phone

City

Street Address

State

Zip / Postal Code

Age (some programs have age specifications)

Gender

Race

Characteristics

Your Motivation: Why do you want to pursue an Experience Matters program at this career and life stage? What is your key impetus or future aspiration? Discuss how your interest derives from your career experiences, personal values, and any prior involvement with specific social issues

Your Qualifications: Provide a brief summary of the relevant experiences, skills, and knowledge you would bring to an Experience Matters program. Include any specific areas of your functional expertise or prior work experience which you hope to apply.

Personal Characteristics: Please also include any pertinent information about your unique Personal Characteristics that might help us get to know you and understand your needs in a service assignment.

(i.e types of projects, working environment, personal values align with organization and mission)

Skills Assessment

Please rate your skill level in the following areas. Indicate your highest proficiency level for each category. Only select skills that apply to you.

Accounting (Accountant, Comptroller, CPA)

Business Strategy (Senior Business Analyst, Strategic Planning Analyst, Management Consultant)

Communications (Public Relations, Specialist/Manager, Corporate Communications)

Copywriting (Copywriter, Writer, Communications Manager)

Database Design/Management (Salesforce/Raisers Edge, Data Migration, Data Cleansing, Database Analyst)

Event Planning (Event Planner)

Facilitator (Business, Training, Conflict Resolution, Small Group)

Finance (Financial/Investment Analyst, Management Consultant, Investment Banker, Private Equity)

Fundraising (Development Director, Grantwriter, Director/Manager of Business Development)

Human Resources (HR Manager, Recruiter, Compensation/Analyst)

Legal (Attorney, General Counsel, Solicitor, Paralegal)

Marketing and Branding (Marketing Manager/Director, Marketing Analyst , Brand Strategist, Creative Director, Product Manager)

Online Marketing (Digital Marketing Specialist, Social Marketing Manager, Online Marketing Analyst)

Photography (Photographer)

Public Relation (Public Relations Specialist/Manager, Communication Manager)

Social Media (Social Media Specialist, Digital Community Manager, Social Marketing Specialist)

Technology (Software Engineer, IT Architect, Systems Administrator/Engineer)

Teaching/Education (Professional Educator, Education Administrator)

Web Design (Creative Director, Graphic Design/Artist, Desktop Publisher, Visual Web Designer)

If you would like to note skills other than those listed above, please describe here.

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Adult Resources	Animal Welfare	Children, Youth, and Families
Education and Literacy	Environment/Conservation	Fine Arts & Culture
Health Care	Homelessness	Human Services
Hunger	Religious	Women’s Issues

Disabled (mentally)	Disabled (physically)
Drug and alcohol addicts in recovery	Elderly (incapacitated – physically or mentally)
Elderly (independent)	Elementary-age children
Formerly incarcerated individuals	GLBT community
Homeless	Infants
Middle School-age children	Physically ill or incapacitated individuals
Specific racial/ethnic groups	Toddlers
Teens	Those in a particular generation