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?
- 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.Format: (000) 000-0000.
- Would you like to include your Racial Identity?
- Racial Identity
- 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.)
- 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)?
  
  Other
- 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?
- 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: