LeadUS Mentoring Program 2015-16

Knowledge Works Learning Academy, Inc./ Kai Wa'Diya Learning Academy- KWLA Board of Directors Applicant Form

Making an Eternal Difference in the lives of children
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Business/Work Information
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Please list your current and past Board experiences, if applicable*
What are your current associations and/or club affiliations (include titles, roles and responsibilities if possible)*
Please list your skills and expertise*
What is your educational background?*
Please describe in detail some of your greatest strengths and weaknesses*
What do you feel is essential to ensure that the Board and staff are successful in attaining the goals for this organization? *
What experiences, expertise, connections, or resources would you bring to KWLA? *
Please detail your interest in joining this Board*
What type of Board tasks do you prefer?*
Directors of the KWLA Board might take on special projects, in addition to their Board responsibilities, to assist KWLA in day-to-day operations, community collaborative organizations, workshops, and scholarship initiatives. Please let us know if you have any specific project ideas you would like to propose. *
Have you ever been engaged in any specific fundraising efforts? If so with whom, how, and what was the amount raised? Are you comfortable playing an active role in assisting KWLA with fundraising efforts? *
The KWLA Board will initially have 4 standing committees: (1) Board Building & Governance, (2)Development, (3) Finance & Human Resources, and (4) Programs. Please check all that you would be interesting in joining.*

Board Building & GovernanceFinance & Human ResourcesDevelopmentProgramOther
How much time would you have to dedicate to KWLA Executive Board ( six months; 3 years, etc.)*
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KWLA’s Board is an exciting and engaged working board. Board members are required to participate in a minimum of 4 board conference calls per year, 4 quarterly meetings, one annual face-to-face meeting once a year, and a minimum of 11 standing monthly committee meetings, which occur outside of regular boardmeetings (this can happen by phone or internet). Board members are expected to be timely and present at every meeting with a maximum of two absences from board meetings. Between work within and outside of meetings, hours of commitment would probably vary between 3-5 hours per month. Board members are also encouraged to participate in fundraising and development activities, which include an annual gift to KWLA, Inc., that is personally significant and meaningful. Board members are expected to commit to the role fora minimum of one year. Will you be able to make this commitment to KWLA, Inc.? _____ Yes _____ No __ Maybe: Please indicate any concerns below: . . PLEASE ADD ANY ADDITIONAL INFORMATION YOU WOULD LIKE US TO CONSIDER
After your application has been reviewed you may be asked to interview in order for us to better get to know you. Please have a list of references available upon request. Thank you for your interest. I certify, by my signature, that the information contained within this application and all supporting documents (i.e., resume, recommendation letters, etc.) is true, accurate, and complete to the best of myknowledge. An electronic signature is accepted.

Knowledge Works Learning Academy, Inc/ Kai Wa'Diya Learning Academy- KWLA, Inc., does not discriminate against any persons – regardless of race, sex, sexual orientation, religion or beliefs. KWLA, Inc., admits students/adults of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. We do not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other school-administered programs.
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Knowledge Works Learning Academy, Inc./ Kai Wa'Diya Learning Academy- KWLA Board of Directors Applicant Form

Personal Information

Demographic Information

Business/Work Information