GOVERNING BOARD - NEW MEMBER APPLICATION

Dear Applicant,

We are so excited for your interest to join our Governing Board. Please fill out the Governing Board Application and Applicant Disclosure Statement below and submit it along with a recent resume. Our team will contact you regarding your interest in joining our Board.

Again, we are so excited for your willingness to help our learners and our team. Thank you!

First Name *

Last Name *

Email *

Date *

Address *

Country

City

State

ZIP code

Home Phone *

Mobile Phone

Work Phone

Brief Biography *

1. Please write a brief biography outlining your experience with schools, community service experience, non-profit work, or employment experience, as it pertains to serving on a Charter School Board.

Why Interested *

2. Why are you interested in our organization and why are you interested in serving as an appointed Charter School Board Member?

Contributions *

3. Please describe contributions that you feel you can make to this Charter School Board if chosen as a member.

Vision of Community *

4. Please describe your vision of community outreach for the Charter School Board.

Critical Issues *

5. What do you believe are the most critical issues facing schools today and how would you contribute as a school board member?

Expectations of Time *

6. What is your expectation of the time requirements of School Board membership?

APPLICANT DISCLOSURE STATEMENT

You must answer all items on this form.

Please check ANY of the following for which you have been convicted in any degree, including any of these crimes as they may have been renamed; (the term “convicted” includes all instances in which a finding of guilty, a plea of guilty or nolo contenders, or stipulation to facts, or deferred to suspended sentence occurred.)

Assault, Manslaughter, Murder or Vehicular Homicide *

Yes

Arson, Burglary, or Robbery *

Yes

Kidnapping, child abuse, neglect

Yes

Rape, Indecent Exposure, or Liberties *

Yes

Custodial Interference *

Yes

Misconduct with a Minor *

Yes

Criminal Abandonment, Mistreatment, or Malicious Harassment *

Yes

Extortion *

Yes

Promoting, Selling, or Distributing Prostitution or Pornography *

Yes

Manufacture, Delivery or Possession of a Controlled Substance *

Yes

Confirm No Conviction *

Please check here if you have NOT been convicted of ANY of the above, including any of these crimes as they may have been renamed.

I have not been convicted of any of the above.

Present Charges *

Are you presently charged with, but not convicted of, any of the crimes or offenses described above?
IF YES, EXPLAIN BELOW:

Yes

Please explain here... *

Signature *

I certify under penalty of perjury under the laws of the State of Colorado that the foregoing is true and correct.

Reset Signature

GOVERNING BOARD – NEW MEMBER APPLICATION

APPLICANT DISCLOSURE STATEMENT

Colorado SKIES Academy