ASGNO Board Member Application

Name*

First NameLast Name

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

How did you hear about our Board Recruitment?*

Which board member reached out to you about this application?

Board Member's Name

ASGNO is actively seeking to ensure our board is representative of the diverse community we serve. We need voices from many different communities to ensure our activities are able to meet the needs in our area. If you are comfortable answering these demographic questions, please select all that apply. Answering or not answering these questions will not impact your eligibilty for a board position.

Options are based on the most common demographics of our area, please use the "other" box to add any additional options needed

Parish *

Age (Applicants must be at least 18 years of age)*

Connection to Autism Community (select all that apply)*

Race/Ethnicity*

A strong non-profit board of directors includes individuals with a wide range of skills and abilities. Please select all that apply to you below.

Please select all options that apply to your current skills and knowledge*

Languages you speak and/or read fluently*

The Board of ASGNO is a working board which means we are seeking applicants who are able and willing to dedicate their time to the organization on a regular basis. Please select all options below that apply to your interest and ability to dedicate your time and resources to our work.*

On Average, how many hours a month are you able and willing to dedicate to the activities you selected above*

0-3 hours3-6 hours6-9 hours10 or more hours

ASGNO Board Member Application

Please answer the questions below to the best of your ability