BOARD OF DIRECTORS

Submitting Email*:

Candidate's First/Last Name:

Candidate's Home Phone Number:

Candidate's Email:

Candidate's Work Phone Number:

Candidate's Employment/Position:

Candidate's Education (please provide a copy of resume below):

Candidate's Resume:

Candidate's Previous Volunteer Experience (if any):

Candidates Skills/Experience (check all that apply):
Finance/AccountingManagement, Administration, Business ProcessLegalCommunity Engagement, Local/State GovernmentEducation, Teaching, Youth DevelopmentNonprofit ManagementFundraising/DevelopmentPublic Relations/CommunicationsOther

If Other, Explain:

Candidate Affiliations or Organizations - Especially Positions of Leadership (e.g., proffesional, civic, etc...):

Why do you feel this candidate would be a positive addition the ARC board - or why would you like to serve on the ARC board (if self-nominating):

Please complete this section if you are nominating yourself.

I doI do not
have any perceived or real conflicts of interest that would prevent me from serving on the board. (e.g., board member or staff of competing program, family members employed by, support for any legal claim or action made against ARC.)

If you do have conflicts of interest, please list them here:

I understandI do not understand
but am willing to learn about the fiscal and oversight functions of a board of directors under both regulations and best practices.

I canI cannot
meet the commitments of the board member job description.

Please complete this section if you are nominating someone else.

Your Name:

Your Phone:

Your Email:

Date of Nomination:

Has this person been contacted to determine their interest in being nominated?
YesNo

If “yes,” would he/she be willing to serve if elected?
YesNo

Do you believe there are any perceived or real conflicts of interest with this candidate?
YesNo

If yes, please list: