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 is seeking applicants to fill positions on the Autism Society NWPA Board of Directors.  

The Autism Society desires individuals who reflect diversity including, but not limited to, age, gender, sexual orientation, geography, economic status, disability, and ethnicity.  Serving on the board is a rewarding experience and an opportunity for personal and professional growth. Completing this form will help us understand the skills you bring to this leadership role.  

This application will be kept confidential and on file at the Autism Society NWPA office.  Applications are used by the Board’s Governance Committee to identify and evaluate potential board candidates. All new directors are elected by a majority vote of current board members and serve a three-year term.

We create connections, empowering everyone in the Autism community with the resources needed to live fully.

Any questions?  Please call the office (814) 455-3540.
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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?
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Please check the following skills you are able to contribute. *
Required
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.
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