Join the Elders Council Application - Baobab Black Seniors Care

Join the Elders Council Form

Join the Elders Council

Your wisdom. Your leadership. Your voice matters.

Baobab Black Seniors Care is forming an Elders Council to ensure that Black seniors can guide the programs, services, and priorities that affect their lives.

First Name

Middle Name

Last Name

Phone Number

Address

Age Group (please check one)

50 and below

51-60

61-75

76 and above

Do you identify as a Black senior (55 years and above)?

Yes

Which country are you or your parents originally from?

Questions

1. Tell us about yourself and what community engagements you have been part of.

2. What lived experiences and cultural knowledge would you bring?

3. What programs, services, or other ideas for Baobab would you advocate for?

4. What changes would you like to see so that Black seniors receive fair, respectful, and culturally safe care?

5. What do you want to see changed or improved for Black seniors in British Columbia (BC)?

6. What priorities or services for Black seniors do you believe are most urgent? Please rank up to three.

7. How have you advocated before, or worked toward change for Black seniors (in BC or elsewhere)?

8. Why do you want to serve on the Elders Council?

9. What do you consider your strengths when working in groups, providing guidance, or decision-making?

10. Can you describe a time when you helped resolve a problem or issue in your community or among seniors? What did you do?

11. What challenges do you foresee in this kind of role, and how would you address them?

12. What expectations do you have of the Elders Council (communication, time commitment, support, etc.)?

13. Is there anything else you would like us to know about you?

14. Can you tell us about your background and how it shapes your approach to our work at Baobab?

Agreement & Signature

I certify that the information I have provided is accurate to the best of my ability. I understand that serving on this Council will involve regular meetings, participation in planning and advocacy, and working respectfully with other members and the organization.

Initials (to show consent):

Date / Time