Board of Directors Application

Board Candidate Application
Please complete the application below.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
District*
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- Have you served in the military?*
  
  YesNo
- How many years did you serve?
- Please describe your military service including any positions held
- Name of college #1 attended*
- Degree/Certificate #1*
- What is your degree/certificate in?*
- Notable accomplishments at college #1*
- Name of college #2 attended
- Degree/Certificate #2
- What is your degree/certificate in?
- Notable accomplishments at college #2
- Name of college #3 attended
- Degree/Certificate #3
- What is your degree/certificate in?
- Notable accomplishments at college #3
- Name of college #4 attended
- Degree/Certificate #4
- What is your degree/certificate in?
- Notable accomplishments at college #4
- Please describe your career experience including years of service for each position.*
  Example: Currently, I am the Chief Communications Officer at Charles LLC, an advertising agency in Fort Wayne and have held this position since 2015. Previously, I worked in public relations as the Communications Director at Parker Industries. I've also done private consulting for different non-profit organizations in Allen County where I helped raise $850K through leading various fundraising campaigns. I also recently started teaching a social media class at Indiana Tech in Fort Wayne.
- Please describe your community involvement.*
  Example: I've served on the board of the Whitley County's Chamber of Commerce for five years. My wife and I serve in the children's ministry at our church. I also volunteer with Big Brothers Big Sisters weekly.
- Please include any family or personal information you'd like included.*
  Example: I've been married to my husband, Lars, for 17 years. Together, we have three children who were all raised in Whitley County. As a family, we enjoy spending our weekends hiking or you can find us at the beach along Lake Michigan. Our family also includes our dog, Scout.
- How many years have you lived in the NREMC service area?*
- Please describe why you would like to serve on the NREMC board of directors.*
- I affirm and certify that all the information and answers to questions herein are complete, true and correct to the best of my knowledge*
  
  Clear
- By submitting my name to the nominating committee comprised of three Northeastern members, I am requesting to be a candidate in the election taking place September xx, 2026.I understand that I must complete an online director candidate orientation training program, which will take approximately two to four hours, by April xx, 2026, before being granted an interview with the nomination committee.
- Today's date*
  
  MonthDayYear
  Date
- Should be Empty:

Board Candidate Application