KSBA Unemployment Program Board of Trustees Application
Please fill in the form below.
Name
*
First Name
Middle Name
Last Name
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number
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Area Code
Phone Number
Mobile Phone Number
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Area Code
Phone Number
E-mail
*
Education Background
*
Name of School District in which you work or serve on the school board
*
What is your current role in the school district?
*
School Board Member
Superintendent
School Finance Officer
Primary Occupation
When did you begin service on your board?
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Month
-
Day
Year
Date
When does your current term expire?
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Month
-
Day
Year
Date
(Optional) Please provide any other information that you'd like to share about your interest in serving on this board (i.e. other work, community, volunteer, or life experiences, and/or knowledge, skills, and abilities you have that would be helpful in doing the work of this board)
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