Request edit access
Kentucky Health Justice Network Board Application
If you want to make a direct impact on improving healthcare access, as well as parenting, childcare, the environment, the economy, housing, and more, you can make a difference with KHJN -- because all those issues matter to reproductive justice.

Kentucky Health Justice Network builds the power of Kentuckians to achieve reproductive justice. We support this mission through direct support, education and outreach. We envision a state where all Kentuckians are empowered to make decisions about their bodies, their lives, and their reproductive health free from barriers, stigma, and oppression. Currently, our programs emphasize (1) abortion funding and support, (2) support for trans people accessing healthcare, (3) access to contraception, and (4) community education.

KHJN invites you to apply for a position on our Board of Directors. As a board member, you will participate in monthly meetings, as well as committees, fundraising activities, and community education events, where you will impact how KHJN fulfills our mission and vision for the community we live in.

As an organization committed to reproductive justice, we have a responsibility to create a pipeline of leadership and development opportunities for young people, low-income people, people of color, LGBTQIA people, people with disabilities, and others who are repeatedly and systematically affected by reproductive inequities. We believe people directly impacted by these issues are best positioned to design and lead solutions.

People of color, people of differing abilities, young people, people who have had an abortion, and LGBTQIA people are strongly encouraged to apply. We are also particularly seeking individuals with financial and legal backgrounds. Anyone over the age of 18 is welcome to apply.

Not all people who apply will be invited to join the KHJN board, however, all people who believe in the reproductive justice framework are welcome to be part of this work as volunteers. There are many ways to support and influence KHJN's work, and we will share those opportunities with you throughout this application process.

**If English is not your primary language and you would like support in completing this application, please contact us at info@khjn.org for accommodations.**
Untitled Title
Your name *
Phone number *
Email *
City, county, or ZIP code in which you currently reside *
If a KHJN board member or staff person referred you to this application, please list their name here:
What skills, connections, resources, and expertise do you have that can further KHJN's mission? *
Examples might include: community organizing, healthcare service experience, financial management, legal knowledge, event planning, human resources expertise, life experience, etc.
Why are you passionate about reproductive justice and the mission of KHJN? *
Kentucky Health Justice Network builds the power of Kentuckians to achieve reproductive justice. We support this mission through direct support, education and outreach. We envision a state where all Kentuckians are empowered to make decisions about their bodies, their lives, and their reproductive health free from barriers, stigma, and oppression. Currently, our programs emphasize (1) abortion funding and support, (2) support for trans people accessing healthcare, (3) access to contraception, and (4) community education.
Have you ever served as board member or in a volunteer leadership role? *
If so, where and when? What were your responsibilities?
Optional: Please describe any formal education, professional certifications, or memberships/affiliations you have that you feel are relevant to board service.
Examples might include: accountancy or paralegal certification, labor union membership, childcare provider certification, RN, MSW, JD, gender studies degree/certificate, etc.
Optional: Do you identify as an individual with a low to moderate income?
This question is optional and will help the KHJN board ensure our board accurately reflects the demographics of the communities we serve. Responses from all applicants may be used in aggregate form for the purposes of grant reporting, but your individual responses to this question will not be shared publicly, or within the organization without your consent.
Clear selection
Optional: How do you identify your gender? Check all that apply.
This question is optional and will help the KHJN board ensure our board accurately reflects the demographics of the communities we serve. Responses from all applicants may be used in aggregate form for the purposes of grant reporting, but your individual responses to this question will not be shared publicly, or within the organization without your consent.
Optional: Do you identify as a person of color?
This question is optional and will help the KHJN board ensure our board accurately reflects the demographics of the communities we serve. Responses from all applicants may be used in aggregate form for the purposes of grant reporting, but your individual responses to this question will not be shared publicly, or within the organization without your consent.
Clear selection
Optional: What is your native language? Additionally, do you speak other languages?
This question is optional and will help the KHJN board ensure our board accurately reflects the demographics of the communities we serve. Responses from all applicants may be used in aggregate form for the purposes of grant reporting, but your individual responses to this question will not be shared publicly, or within the organization without your consent.
Time commitment acknowledgement *
KHJN board meetings typically last two hours, once per month, with additional time and service expected of all board members, such as committee participation and fundraising activities. Currently our meetings occur via video, however we hope to resume quarterly in-person meetings as circumstances permit. Typically our in-person meetings occur in Louisville where our office is located, but depending on shifting Board composition we are open to varying the location of our in-person meetings. So there may some travel, as well as access to a computer and internet, required for board participation.   If selected to be on the KHJN board, do you anticipate you will be able to commit to participating in all meetings? And will you need any specific kinds of support to participate in meetings?
Financial contribution acknowledgement *
Each KHJN board member is expected to make a financial contribution of an amount that is realistic and meaningful for them. If selected for the KJHN board, do you anticipate you will be able to make a financial contribution of an amount that is realistic and meaningful for you? A "no" answer does not immediately disqualify you from serving on the KHJN board; if "no," please share in the OTHER box why you would not be able to do so.
Conflict of interest acknowledgement *
KHJN board members are expected to make decisions in KHJN's best interest, not for any personal gain or advantage or to advantage or disadvantage another business or organization. To your knowledge, do you have any relationships or business interests that would present a conflict of interest with serving on the KHJN board of directors?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy