Alliance for Higher Education in Prison Advisory Board Member Application
Thank you very much for your interest in serving on the Alliance for Higher Education in Prison (Alliance) Advisory Board. This form can be used to submit your self-nomination to join the Advisory Board.

The purpose of the Advisory Board is to advise, assist, support and advocate for the Alliance for Higher Education in Prison (the Alliance) in line with its stated mission: “To support the expansion of quality higher education in prison, empower students in prison and after release, and shape public discussion about education and incarceration.”

The Alliance does not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, current or former incarceration experience, or sexual orientation in any of its activities or operations.

Email address *
Please confirm your email address *
Your answer
Name *
First, MI, Last
Your answer
Mailing Address *
Business address preferred. If using a personal address, include only city, state and zip code.
Your answer
Phone Number *
Your answer
Are you a formerly incarcerated individual? *
Age *
Race/Ethnicity *
Required
Current Organizational Commitments *
Please include all organizations you currently serve. If employed, please include the name of your current employer and your title. If you are a student, please include the name of your university. Include the name(s) of the organization(s) and your role(s).
Your answer
Have you previously served on a nonprofit board? *
If yes, please list the name(s) of the organization(s), your role(s), and the dates of service.
Your answer
Why you are interested in joining the Alliance Advisory Board? *
Your answer
How do you feel the Alliance would benefit from your involvement on the Board? *
Your answer
Experience/Skills/Interest Areas *
(Please check all that apply)
Required
Please list any groups, organizations or businesses you could serve as a liaison to on behalf of the Alliance.
Your answer
Is there any other information that you believe is pertinent to share with the board related to your application?
Your answer
If you join the Alliance Advisory Board, do you agree to the following? *
Yes
No
I can provide at least 2-4 hours per month in attendance at Board and Committee Meetings?
I do not have any conflicts of interest with participating as an Advisory Board member.
A copy of your responses will be emailed to the address you provided.
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