Board of Directors | Application of Interest

Thank you for your interest in serving as a member of the Board of Directors of the Autism Society Northwestern Pennsylvania (AS NWPA).

We are actively seeking individuals to fill positions on our board, and we value diversity in our candidates, considering factors such as age, gender, sexual orientation, geography, economic status, disability, and ethnicity. Serving on our board offers a rewarding experience and an opportunity for personal and professional growth.

Completing this application will help us better understand the unique skills and qualities you can bring to this leadership role. Rest assured that all information provided will be kept confidential and stored at the Autism Society NWPA office. Our Governance Committee will use these applications to identify and evaluate potential board candidates. New directors are elected by a majority vote of current board members and serve a three-year term.

At AS NWPA, our mission is to create connections and empower everyone in the Autism community with the resources needed to live fully. If you have any questions or need further information, please don't hesitate to call our office at (814) 455-3540.

We appreciate your dedication to our cause and look forward to the possibility of welcoming you to our board. Thank you for considering this important opportunity to make a meaningful impact in the Autism community.

Sign in to Google to save your progress. Learn more
Email *
Name *
First and Last Name
Business/Organization/Affiliation/Title *
Mailing Address *
Street, City, Zip
Home Phone *
Business Phone *
Cell Phone *
Would you like to receive text reminders for meetings? *
Must provide a cell number to be included in text reminders.
Do you identify as being on the autism spectrum?
Clear selection
Please check the following skills you are able to contribute. *
Required
Community Connections
How would you describe your interpersonal style? *
Time, Talents & Treasure 
Will you commit to attending board meetings on a regular basis and serve on at least one committee of the Board? *
What committee(s) would you be interested in joining? *
Required
Board orientation is required.  Are you willing to commit the time required (two hours) to be appropriately oriented to the organization? *
Typically held at the January board meeting
Are you willing to attend Autism Society NWPA functions such as trainings, fundraising, and other events? *
List at least two reasons you wish to serve on the Board of Directors. *
Have you served on any Board of Directors and if so, please list the organizations and dates of service. *
Please provide 2 or 3 references or other information that may be pertinent to you serving on the Board of Directors. *
Do you have a close relationship with anyone who has autism? *
Please provide any other pertinent information about yourself.
Please provide the name of who is recommending you for the ASNWPA Board of Directors. *
THANK YOU FOR YOUR INTEREST.
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Autism Society NWPA. Report Abuse