2021 ACSSW New Board Member Application
Thank you for your interest in joining the ACSSW Board of Directors. The Board will review applications and select up to 6 applicants for 20–30 minute interviews on July 22 from 1:00– 4:00 Central Time via Zoom. Selected applicants will be scheduled only at this time. Please contact ACSSW Board Member, Stacy Gherardi at sgherard@nmsu.edu, if you have any questions.
Email *
Clear selection
Personal Demographics
Please provide your contact information via each question below.
Full Name (First and Last) *
Email Address *
Re-Enter Email Address *
Cell Phone Number *
Home Address (Number and Street) *
Home Address (City or Town) *
Home Address (State) *
Home Address (Zip Code) *
Professional Background & Experience
Please provide details regarding your professional experience via each question below.
Current Position *
Professional Title *
Credentials & Licensing *
Place of Employment *
Employer City *
Employer State *
Please provide the full name and email address of one professional reference. *
Please provide a brief personal bio. *
Briefly describe your professional experience in relation to the practice of school social work. *
Why do you wish to be considered for an ACSSW Board Member position? *
Briefly describe your past and/or current experience serving on a Board of Directors. *
Of the following - which are your strengths, talents and interests? Check all that apply. *
Required
How will you apply your skills to support & enhance the work of the Board and the profession of SSW? *
What are you doing now that could strengthen the work of the ACSSW Board and the SSW profession? *
Does your schedule permit you to fully participate in ACSSW's 2 hour monthly Board teleconferences? *
Are you able to commit up to 10 hrs/month working on ACSSW Board activities including meetings? *
Does your schedule permit you to travel to attend in-person Board meetings? *
Are you able to commit to being a Board member for two full years? *
ACSSW is a working Board with several committees and Thematic Groups. In which two would you be most interested? *
Required
ACSSW has tasks that need commitment and dedication. To which can you bring your talents? *
Required
Does your employer support your membership and participation as an ACSSW Board Member? *
Do you presently serve on any professional Boards or committees? *
If you presently serve on any professional Boards or committees, please indicate which ones.
I have read and understand the info packet and attest that I am able to complete the requirements. *
Is there anything else you would like to share with the Board Member Search Committee?
What questions, if any, do you have about serving as a member of the ACSSW Board of Directors?
Please email your resume/CV to Board Member Stacy Gherardi at sgherard@nmsu.edu as soon as you submit this form. Your application will not be complete without this additional step.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy