• Speak Up! Community Outreach Board Member Application

    Thank you for your interest in serving on the Board of Directors for Speak Up! Community Outreach. We are seeking dedicated individuals who are passionate about supporting families of children with disabilities and special needs.

  • Applicant Information

  • Format: (000) 000-0000.

  • Eligibility & Basic Questions

  • Are you at least 18 years old?*
  • Are you legally eligible to serve on a nonprofit board in our jurisdiction?*
  • Are you willing to commit to a board term of 2 and attend quarterly meetings?*

  • Professional & Board Experience

  • Prior board service?*
  • Areas of expertise*

  • Skills, Interests & Motivation

  • Focus areas of interest

  • Optional Diversity & Demographic

  • Optional Diversity & Demographic Information
  • Race / Ethnicity

  • Conflicts of Interest & Compliance

  • Do you or your immediate family have any financial or personal interests that could be perceived as a conflict with the organization’s mission or activities?*
  • Are you currently employed by, or serving on the board of, any organization that may interact with this nonprofit (such as funders, vendors, partners, or competitors)?*
  • Are you willing to complete and sign a Conflict of Interest disclosure annually?*
  • Are you willing to adhere to the Code of Conduct and Confidentiality Policy?*

  • References & Attachments

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Permission to Contact References*
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  • Declarations & Consent

  • Declarations*
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Applicant Name
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