Board Service & Engagement Agreement (2026)

Thank you for your service to Maybelle Center. This annual form is designed to support a shared understanding of board responsibilities, help us align board engagement with individual interests and capacity, and ensure we meet our governance and fundraising commitments together.

The form is divided into four sections and should take approximately 15–20 minutes. You can save and continue the form at any time.

1Responsibilities & Expectations

2Conflict of Interests

3Your Engagement

4Financial Gift Planning

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Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State Zip

# of years on the Board

Please enter a number from 1 to 9.

Board Service Responsibilities & Expectations

By serving on the Board, I agree to:(Required)

	Agree	Disagree
Demonstrate a genuine commitment to Maybelle Center’s mission, values, and goals.
Uphold my fiduciary duty to oversee the integrity of the organization.
Serve as an ambassador for Maybelle Center by sharing our story, building relationships, and making meaningful connections in the community.
A time commitment of approximately 30–40 hours per year, including ~4 hours per quarter for Board Meeting preparation and attendance, ~2 hours for the remote budget meeting in December, and ~12-22 hours participating in at least one standing or ad hoc committee and occasional participation in other events as requested.
Attend all board meetings in person whenever possible, and use virtual attendance only in exceptional cases, with prior notice. If a board member misses more than one meeting in a year, they should discuss their attendance with the Board Chair or Executive Director.
Participate actively in at least one standing or ad hoc committee.
Make an annual financial contribution that is meaningful to me. A typical contribution is $100 per month ($1,200 annually), though meaningful contributions may also be met through other approved means.
Actively support fundraising and resource development efforts in ways that align with my skills, comfort, and networks.
Participate in board orientation and engage in ongoing learning related to board governance and Maybelle Center’s work.
Assist with board recruitment and cultivation.
Comply with Maybelle Center’s Conflict of Interest Policy, including promptly disclosing any actual or potential conflicts that arise during board service.
Participate annually in at least one volunteer visit or meaningful interaction with a Resident or Member, such as attending a community room activity or member-focused event, if possible.

Annual Conflict of Interest Disclosure

Policy Acknowledgement(Required)

Maybelle Center Conflict of Interest Policy-Rev 2/2026

This policy applies to all:
1. Members of Maybelle Center’s Board of Directors (“Board Member,” collectively, “The Board”)
2. Maybelle Center employees at the director level or equivalent (“Officers,” collectively, “Leadership Team”)

Purpose
The members of the Board of Directors and officers of Maybelle Center must always act in the best interests of Maybelle Center and those we serve. The purpose of this policy is to help inform the Board and officers about what constitutes a conflict of interest, assist in identifying and disclosing actual and potential conflicts, and help ensure the avoidance of conflicts of interest where necessary.

Conflicts of interest must be taken very seriously since they can damage Maybelle Center’s reputation and expose both Maybelle Center and affiliated individuals to legal liability if not handled appropriately. Even the appearance of a conflict of interest should be avoided, as it could undermine public support for Maybelle Center.

This policy is meant to supplement, not replace, any applicable state and federal laws governing conflicts of interest for nonprofit and charitable organizations.

Definitions or Key Terms
• Conflict of Interest: A conflict of interest is a transaction or relationship that presents or may present a conflict between a Board member’s or employee’s obligations to Maybelle Center and the Board member’s or employee’s personal, business, or other interests.
• Fiduciary duty: An obligation that prohibits individuals from prioritizing their own interests over the organization's interests.
• Interested vis disinterested: Board members or officers with a conflict are “interested.” Board members/officers without a conflict are “disinterested.”

Policy Statement
Board members and officers have a fiduciary duty to conduct themselves without conflict with the interests of Maybelle Center. In their capacity as Board members or officers, they must subordinate personal, individual business, third-party, and other interests to the welfare and best interests of Maybelle Center.

All conflicts of interest are not necessarily prohibited or harmful to Maybelle Center. However, full disclosure of all actual and potential conflicts, and a determination by the disinterested Maybelle Center’s Board members and Leadership Team – with the interested board member(s)/officers(s) recused from participating in discussions and voting on the matter – is required.

Procedures
Duty to disclose
All actual and potential conflicts of interests shall be disclosed by Board members and officers to Maybelle Center through the annual disclosure form, and/or whenever a conflict arises.

1. Board of Directors: On an annual basis, during the Quarter 1 Board meeting, all board members shall be provided with a copy of this Conflict of Interest Policy and required to complete and sign the Conflict of Interest Disclosure Form. All completed forms shall be provided to and reviewed by the Executive Director, as well as all other conflict information provided by Board members.

2. Leadership Team: Officers shall be provided with a copy of the Conflict of Interest Policy in the first quarter and required to complete and sign the Conflict of Interest Disclosure Form. All completed forms shall be provided to and reviewed by the Executive Director, as well as all other conflict information provided by officers.

Determining whether a conflict of interest exists & required action
1. The disinterested members of the Board and Leadership Team shall decide as to whether a conflict exists and what subsequent action is appropriate, if any. Interested board member(s)/officer(s) should be recused from participating in discussions and voting on the matter.

2. Maybelle Center’s Board and Leadership Team shall inform the interested board member(s) or officer(s) of such determination and required action.

The Board shall retain ultimate enforcement authority over the interpretation and application of this policy.

I have read Maybelle Center’s Conflict of Interest Policy and agree to fully comply with its terms and conditions at all times during my service as a Maybelle Center Board member.

Conflict Disclosure(Required)

Please certify below that you either have no actual or possible conflict of interest report, or describe below any relationships, transactions, positions you hold (volunteer or otherwise), or circumstances that you believe could contribute to an actual or possible conflict of interest between Maybelle Center and your personal interests, financial or otherwise:

I have no conflict of interest to report

I have actual or possible conflict(s) of interest to report

Please describe your potential or actual conflict(s) of interest below:(Required)

Agreement to Disclose(Required)

If at any time following the submission of this form, I become aware of any actual or potential conflicts of interest, or if the information provided above becomes inaccurate or incomplete, I will promptly notify Maybelle Center’s Executive Director in writing.

Your Engagement (Current and Future)

Ways You Supported Maybelle Center in 2025(Required)

Please list the ways you supported Maybelle Center with resource development in 2025. Please check all that apply.

Financial Gift

Hosting or sponsoring a table at the annual fundraiser

In-kind gift of auction item

Identifying and introducing potential donors or sponsors

Introducing service partners

Making connections/intro with an elected official or government agency

Inviting guests to tours, quarterly lunches, or informational gatherings

Hosting an informational reception or house party

Making thank-you calls/emails to donors

Event planning or volunteering

Speaking at events

In-kind gift of professional services

Volunteering

Other

Please specify the professional services provided:

Please provide details on the type of volunteering:

If you chose "other," please specify:

Anticipated 2026 Participation(Required)

Please list how to plan on supporting Maybelle Center this year. Please check all that apply.

Financial Gift

Hosting or sponsoring a table at the annual fundraiser

In-kind gift of auction item

Identifying and introducing potential donors or sponsors

Introducing service partners

Making connections/intro with an elected official or government agency

Inviting guests to tours, quarterly lunches, or informational gatherings

Hosting an informational reception or house party

Making thank-you calls/emails to donors

Event planning or volunteering

Speaking at events

In-kind gift of professional services

Volunteering

Other

Please specify the professional services you will provide:

Please provide details on the type of volunteering you would like to do:

If you chose "other," please specify:

Areas of interest or expertise:(Required)

Please choose all the areas where you have interest or expertise to share:

Assisted Living / Community-Based Care

Board Training & Coaching

Board Recruitment

Fundraising & Resource Development

Diversity, Equity, Inclusion & Belonging (DEIB)

Evaluation & Measuring Impact

Facilities / Operations / IT

Finance & Investments

Human Resources / People & Culture

Legal / Compliance

Marketing & Communications

Programming

Mental and Behavioral Health

Strategic Planning

Other

If you chose "other," please specify:

Annual Financial Gift Planning

This section helps Maybelle Center support your giving experience and plan effectively for the year. Responses are confidential and shared only with the Development Team and Executive Director. A typical contribution is $100 per month ($1,200 annually), though meaningful contributions may also be met through other approved means. Please talk to our Development Director or Executive Director to brainstorm ways you can support Maybelle Center.

Annual Giving Pledge(Required)

My 2026 annual giving contribution will be:

Discuss contribution

I would like to discuss my contribution with the Development Director or Executive Director

My preferred payment structure is:

One-time gift

Quarterly installments

Monthly recurring

Undecided / would like to discuss

The source of my pledge is:

(check all that apply)

Personal funds

Employer matching gift

Donor-Advised Fund (DAF)

Stock or appreciated assets

Not sure yet / would like to discuss

Specify employer name:

Specify DAF organization:

Additional comments you wish to share regarding factors that influence your decision on your annual giving amount:

Mutual Commitment(Required)

By signing below, I affirm my commitment to fulfill the responsibilities and expectations outlined in this document and to actively support Maybelle Center’s mission through governance, fundraising, and relationship-building activities.

In return, Maybelle Center commits to: 1. Providing timely and relevant information about organizational operations, including at least quarterly financial statements 2. Responding to questions necessary for fulfilling board responsibilities, and 3. Providing appropriate access to staff for discussion of programs and policy matters