Board of Directors Interest Form

Board of Directors Interest Form

Interested in joining our Community Action Board of Directors? Mark your interest here. Candidates will also be invited to fill out a CAPRW Board Matrix that allows you to give specific details on your experience in the areas we serve.
- Position Description
- Which sector opening do you represent?*
  
  Consumer sector, representing people with low incomes by living and/or working with a low income in Ramsey or Washington CountyPrivate sector, including staff from business, labor, faith-based, private social services, educational, anti-poverty advocacy organizations, academia, community based organizations, non-profit organizations, or other private organizationsPublic sector, including elected public officials currently holding office or appointed staff from local and county governments in either Ramsey or Washington counties, including county boards, city government, and school boards
- Name*
  
  First NameLast Name
- Date of Birth*
  
  MonthDayYear
  Date
- Preferred Email*
  example@example.com - This would be used for official correspondence
- Phone Number*
  Please enter a valid phone number.
- Would you like to include your Racial Identity?
  
  YesNo
- Racial Identity
  
  Asian or Asian AmericanBlack or African AmericanHispanicMiddle EasternMulti-racialNative AmericanNative HawaiianPacific IslanderWhiteNot Listed
- What language(s) do you speak?
- Preferred Language
- Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- Employer Name (if applicable)
- Position (if applicable)
- Resume
  
  You may upload a resume here
  Cancelof
- Please provide a brief statement about your reasons for wishing to serve on the Community Action Board of Directors.*
- Select your applicable background/skills for service on the Board. (Select all that apply.)
  
  Current participant in Community Action program(s) (i.e. Head State, Energy Assistance, Weatherization, rental property tenant, etc.)Low Income life experienceExperience with Community Action at an agency other than CAP-Ramsey & Washington CountiesHead Start Parent or GrandparentCurrent Head Start Policy Council memberPast Head Start Policy Council memberCommunity organizing (formal or informal)Community volunteer (parent council, PTO, youth sports coach, youth mentor, meal delivery, etc)Labor or service industry employmentEarly childhood educationElementary, secondary, or post-secondary educationFaith community member or leaderAdvocacyFinanceAttorneyPR/CommunicationsMarketingOrganizational managementOperations managementHuman ResourcesStrategic planningResource development/fundraisingExecutive experienceResearch and evaluationPublic policyCounty servicesCity servicesEconomic developmentAffordable housingNon-profit professionalNon-profit governanceHuman services
- Please describe your educational background (degrees, certifications, or relevant training). *
- Briefly summarize your work experience*
- What else do you want us to know about you, your skills, or experience as a candidate for the Board?
- Please identify two individuals who will serve as a reference about your experience, skills, and abilities.*
- Are you generally available to attend meetings 1-3 times per month (1-2 hours each)?*
  
  YesNoOther
- Do you have any relationships, transactions, positions you hold (volunteer or otherwise), or circumstances that you believe could contribute to a conflict of interest between CAPRW and your personal interests, financial or otherwise?*
  
  YesNo
- If so, please describe your conflict of interest
  Please specify other nonprofit and forprofit boards you (and your spouse) sit on, any for-profit businesses for which you or an immediate family member are an officer or director, or a majority shareholder, and the name of your employer and any businesses you or a family member own.
- To help us better understand our volunteers and the communities we serve, please indicate if you consider yourself to be part of a low-income household.
- Should be Empty: