Board of Directors Application

Board of Directors Application
- Name*
  
  First NameLast Name
- Email*
  example@example.com
- Phone Number
- Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Date of Birth
  
  MonthDayYear
- Diversity and inclusion is at the core of The Arc of the Capital Area’s mission. We strive to embrace diversity at all levels of our organization, including leadership.
- Ethnicity
  Choose all that apply
- If other, please explain
- Language
- If other, please explain
- Gender
- Occupation
- Title
- Employer
- What is your professional experience? Please explain here.
- Please upload your resume or professional bio here.
  
  Browse Files
  
  Cancelof
- If nomination is by a current board member, please provide the board member's name below.
- What would you consider to be your primary area(s) of expertise. Please choose all that apply.
  
  Health and Human ServicesEmploymentBusiness DevelopmentHigher EducationCommunications, Marketing, PRBranding/MarketingHuman Resources / PeopleAdminstration/ManagementAccounting/FinanceEntrepreneurshipGovernance & OperationsIT Systems & SecurityFundraising and DevelopmentGovermentLawDiversity, Equity, Inclusion, BelongingSpecial EducationMission -Connected/ Disability ConnectionLeadershipTransportationOther
- If any of the above apply, please explain.
- How would you contribute to, and be of value to, our organization? Please choose all that apply.
  
  Major Gift CapacityExperience developing robust earned income modelsSenior ExecutiveCelebrityMarketing and DevelopmentPhilanthrophyEvents PlanningOther
- If any of the above apply, please explain.
- In what ways do you believe you would further our organization's mission?
- Please indicate the type of connections you have in the community that may benefit our organization. Examples: Cowboy Alumni Association or Dell
- Do you have a connection to a person with a developmental or intellectual disability? Please choose all that apply.
  
  ParentSiblingProfessionalSelf advocateInterested CitizenOther
- If any of the above apply, please explain.
- Please describe any prior or current community or volunteer service.
- Please identify any prior or current Board of Directors experience.
- Why are you interested in becoming a board member with our organization?
- What may make it difficult for you to meet the obligations and commitments for a Director? What will you do to ensure you perform all your responsibilities and keep your commitments?
- What, if any,conflicts of interest, current or anticipated, may exist that the Board should know about in considering your application?
- Are you willing and able to comply with the Board’s give/get policy of $2,500 per year? Please check the box below that applies.
  
  Yes, I am willing and able to comply with the Board's give/get policy.I would like more information on the Board's give/get policy.
- Are you willing and able to perform the obligations outlined in the Board of Directors - Overview of Responsibilities? Please check the box below that applies.
  
  Yes, I am willing and able to perform the obligations outlined in the Board of Directors Overview of Responsibilities.I would like more information on the obligations outlined in the Board of Directors Overview of Responsibilities.
- Is there anything else you would like us to know about you?
- By signing, I agree that everything on and attached to this form is correct and accurate to the best of my knowledge. Signature:
- Date
  
  MonthDayYear
- Should be Empty: