board member application

Have you read our responsibilities and bylaws? Still interested? Then please continue on!

Please submit by April 15 to be considered at our next in-person Board of Directors meeting. Board Members will next be considered in May of 2006. Questions? Just ask devra@nolose.org.

* = required
First name:*
Last name: *
Street address: *
Street address (continued.):
City:*
State/province:*
Country:*
Zip/postal code: *
E-mail:*
Primary phone:

Occupation or professional training:*

List your NOLOSE experience that is relevant to your application for a seat on the NOLOSE Board of Directors:*

List your non-NOLOSE experience that is relevant to your application for a seat on the NOLOSE Board of Directors:*

Increasing the diversity of our Board is currently our number one priority. In what ways will your participation with the NOLOSE Board of Directors augment our diversity?*

If you are invited to be on the Board, there will be a six month review period. During this time, we will ask you to carry out a small project on behalf of NOLOSE. This project could be a fundraiser, an activism event, or another happening.

Please include a brief proposal for this project below. *

Conflict of Interest Policy:

NOLOSE requires its leaders to adhere to the following guidelines:

  • Full disclosure: Board members in decision-making roles should make known their connections with groups doing business with the organization. This information should be provided annually.
  • Board member abstention from consensus: Board members who have an actual or potential conflict of interest should not participate in consensus on matters affecting transactions between the organization and the other group.

I have read, and agree to abide by the Board of Directors responsibilities, Code of Ethics, and the Conflict of Interest Policy; and am stating that, in submitting this form with any attachments, all the facts given by me are true to the best of my knowledge and beliefs.