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NRCA Board of Directors Application
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Please enable JavaScript in your browser to complete this form.
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Step
1
of 2
Name
*
First
Last
Address
*
Include Physical Address if different from Mailing Address
Contact Phone Number
*
Email
*
Which jurisdiction of the New River Valley, Virginia do you reside?
*
Floyd County
Giles County
Radford City
Pulaski County
Montgomery County
Are you a current or past recipient of one of NRCA’s services?
*
Yes
No
If you have participated in NRCA services, which program(s)?
Can you commit to attend monthly Board meetings on the third Tuesday at 6:00 PM?
*
Yes
No
Note: Board meeting attendance is critical to ensure a quorum for conduction of business and to maintain member knowledge of Board and agency operations.
Can you commit to participation on a Board committee?
*
Yes
No
Note: Frequency of meetings varies; committees schedule meetings per member availability.
Next
Committee Preference
Please refer to agency bylaws for committee description details at https://newrivercommunityaction.org/board-resource-documents/
Program Planning and Evaluation Committee
First Choice
Second Choice
Third Choice
Fourth Choice
Finance Committee
First Choice
Second Choice
Third Choice
Fourth Choice
Personnel Committee
First Choice
Second Choice
Third Choice
Fourth Choice
Public/Community Relations & Resource Development Committee
First Choice
Second Choice
Third Choice
Fourth Choice
Why are you interested in our organization and serving on this Board?
*
What competencies do you possess that would contribute to your effectiveness as a board member?
*
(What is your relevant experience and/or employment that would benefit the New River Community Action Board?)
What personal qualities do you possess that would contribute to your ability to work effectively with others in furthering the mission of New River Community Action?
*
Disclosure of potential conflict of interest—Do you engage in activities or maintain associations that could be perceived as a conflict with your role as a Board member of New River Community Action?
*
Yes
No
If yes, please explain.
Do you have an immediate family member as defined below employed by NRCA?
*
Yes
No
From NRCA Personnel Policies: No person will hold a job at the agency while an immediate family member serves on an agency board, advisory board, or supervises that position. The immediate family will include any of the following: wife, husband, father, mother, brother, sister, son, daughter, grandfather/mother, in-laws and step-relatives (for those relatives noted previously above), or anyone living in the immediate household.
If yes, please specify name and relationship
Submit
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