NLCUP Board of Directors Application Form
Thank you for your interest in serving on the NLCUP Board of Directors. Please fill out this form, and a member from our team will be in touch.
Name:
*
First Name
Last Name
Pronouns:
*
Current Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email:
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Race & Ethnicity
Gender Identity:
Birth Year:
Current employment status:
*
Full Time
Part Time
Seeking Employment
Retired
Other
Employer's Name (if employed):
First Name
Last Name
Years with current employer:
Years in current field:
*
Current occupation:
*
What is your professional background?
*
What other volunteer positions have you held?
*
Please list your degrees (including the school):
*
In what ways have you interacted with our organization before applying for the Board (examples: committee member, member, donor, event attendee, etc)?
*
Why is our mission important to you?
*
Why do you want to be on our board?
*
If you have served on a board before, please provide the name, dates of service, and reason for leaving for the three most recent board positions:
*
Do we have your permission to contact the organizations listed above to ask about your board service with them?
*
Yes
No
Not Applicable
Each year, every board member is required to disclose any potential conflicts of interest as a board member. Please describe any conflicts of interest you would need to disclose if you joined the board:
*
Board meetings are typically scheduled for the second Thursday of each month from 3:00 to 4:30 PM Central Time. Are you available at this time?
*
Yes
No
The minimum expectations for board members are listed below. Please confirm your ability and willingness to meet each. If selected for the board:
*
I will serve if elected and make every effort to attend and actively participate in Board and Committee meetings.
I will become a member of NLCUP whose membership dues are paid in full, and meet membership requirements.
I will contribute at least $250 to the corporation annually, all or part of which may come from the value paid for or solicited as a direct donation to NLCUP and received by the corporation.
I will serve on at least one committee and make every effort to attend meetings.
I understand that a Director’s fiduciary duty includes the obligation not to disclose and to maintain the confidentiality of the Confidential Information shared by the organization with Board Members in order to permit them to carry out their responsibilities as Directors.
I consent to undergo a thorough background and credit check to be considered to serve as a member of the NLCUP Boardof Directors.
Please provide the times you are available for an interview with the Nominating Committee during the next 2 weeks:
*
Please attach your resume and updated bio to this application.
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