Board/Committee Membership Nomination/Application

Nomination/Application Process

Thank you for your interest in joining one of our organization's Committees and/or Board of Directors. Before completing this form, please review the Board Member Job Description.

Please complete this form. All forms are reviewed by our Board Chair and President prior to appointment.

Members are required to attend meetings and be an active participant of the committee.

All new committee members will have an orientation session.

Nominee Information

Nominee/Applicant First Name

Nominee/Applicant Last Name

Nominee's email address

Nominee's LinkedIn URL

Preferred phone number

Date of Birth - Month & Day Only

Does the nominee have children aged 5 or younger in their care?

YesNo

What are the ages of the children?

Home Address

Street Address

City

State

Zip Code

Work Address

Street Address

City

State

Zip Code

Nominator Information

Nominator's First Name

Nominator's Last Name

Company Name (if applicable)

Phone

Mission & Vision

ABOUT US:

Our vision is to live in an economically prosperous community where families are successful, and children thrive.

Our mission is to achieve our vision, we will be the driving force to engage partners to achieve lasting positive outcomes for all children, beginning at birth.

What we do is focus on support for families with children birth to 5 years old. Our priorities are to provide services and supports that Advance the Well‑being of Children, Strengthens the Early Care Early Education System, and Empowers Families.

To learn more about each committee:

Committee Choices

Committee Nominee/Applicant is best suited for. (Chose all applicable)

Board of Directors (Includes NC Pre-K Planning Committee)Child Care Resource and Referral Advisory CommitteeCommunity Engagement and Development Executive CommitteeFacility & TenantFamily Connects Community Advisory CommitteeFinanceHuman Resource (Must be a current or former Board Member)Planning & Evaluation

Application Questions

How will this nominee contribute to the vision and mission as a leadership member?

What work experience or expertise would this nominee bring?

Resume Upload

List relevant volunteer experience (including boards, committees & community service)

Please list nominee/applicant's personal reasons for being willing to serve

Any additional information you would like to share with us

Authorization

BY SUBMITTING THIS FORM, I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND ACCURATE AND PERMISSION IS GIVEN TO USE THE ABOVE INFORMATION FOR NOMINATION/APPLICATION PURPOSES.