IMTA Board Member Application Members of IMTA in good standing are encouraged to apply to serve on the IMTA Board of Directors. Step 1 of 5 - General Information 20% Name(Required) First Middle Last Title Organization(Required) Language(s) Spoken(Required) Arabic English French Hindi Mandarin Portuguese Indonesian Spanish Standard German Other CONTACT INFORMATIONAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email(Required) Website Phone(Required)Skype Social Media ProfilesFacebookLinkedInX Add Remove CERTIFICATION INFORMATIONYear joined IMTA(Required) MM slash DD slash YYYY Do you currently have an IMTA Teacher Certification?(Required)YesNoCertification Type (check all that apply) CMT-P CMT-M CMT-O AMTT-P Year of First Certification Do you hold any teacher certifications from other organizations? Yes No If yes, list certification/year issued ADDITIONAL INFORMATIONGeneral Experience(Required)Tell us about your background and give us an idea of the experience you have with the mindfulness community.)Education and Certifications(Required)Tell us about your educational pathway, degrees earned, and/or any certifications you currently holdIs this your first board position?(Required)YesNoAre you currently serving on any other boards?(Required)YesNoIf yes, which boards do you serve on and in which positions? Do you believe this would pose any potential conflict of interest?(Required)YesNoIf yes, please describe GENERAL BOARD SKILLSExperience in Mindfulness Sector No Experience Some Experience Highly Experienced Board Service No Experience Some Experience Highly Experienced Non-Profit Governance No Experience Some Experience Highly Experienced Accreditation Best Practices No Experience Some Experience Highly Experienced Certification Programs No Experience Some Experience Highly Experienced Knowledge of Broad Issues Impacting Mindfulness Teachers and Practitioners No Experience Some Experience Highly Experienced Strategic Thinking and Planning No Experience Some Experience Highly Experienced International Relationship Management No Experience Some Experience Highly Experienced Interpersonal Communication Skills No Experience Some Experience Highly Experienced Reading Financial Statements No Experience Some Experience Highly Experienced Understanding Risk Management Concepts No Experience Some Experience Highly Experienced Coalition Building No Experience Some Experience Highly Experienced Marketing and Public Relations No Experience Some Experience Highly Experienced Professional Development No Experience Some Experience Highly Experienced Member Value Creation No Experience Some Experience Highly Experienced