Application: High Performing Inclusive Organization (HPIO) Chair

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* 1. I am a member of Iowa AEYC/NAEYC. (This position is only open to members of Iowa AEYC. If you are interested in serving in a leadership position with Iowa AEYC and you are selected for this position, you must become a member within 60 days of your appointment. You can learn more about memberships and join at www.iowaaeyc.org.)

Yes

No, but if selected, I will become a member within 60 days

Other (please specify)

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* 2. Please list your previous board experience and approximate dates served.

1. Board Name

Position

Dates of Service

2. Board Name

Position

Dates of Service

3. Board Name

Position

Dates of Service

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* 3. Contact Information

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 4. Demographic Information- Ethnicity

Demographic Information is collected in order for Iowa AEYC monitor the balance of the board. Your demographics are not used to accept or decline applications.

Other (please specify)

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* 5. Demographic Information- Age

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* 6. Which of the following areas could you represent as a board member? Select all that apply.

Family Childcare

For Profit Childcare

Faith Based

Headstart

Voluntary Preschool

K-3

Department of Education

Family Support

Higher Education

Health/Mental Health

Advocacy/Law Field

Financial Field

Human Resources

Community Connection

Family Representative

Other (please specify)

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* 7. Why are you interested in serving as the High Performing Inclusive Organization Chair on the Iowa AEYC Governing Board? (250 words or less)

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* 8. What experiences and qualifications do you bring with you that would help elevate Iowa AEYC and support efforts to be a more inclusive organization? (250 words or less)

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* 9. I am able to meet/fulfill the requirements below.

I believe I am qualified for the High Performing Inclusive Organization Chair position. (Position description)

I understand that if chosen for the High Performing Inclusive Organization Chair, that the position is a 2 year commitment.

I am able to commit my time to fulfill the duties and responsibilities for the High Performing Inclusive Organization Chair position. (2023-24 Meeting Schedule)

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* 10. I agree to abide by the NAEYC Code of Ethical Conduct.

Yes

Application: High Performing Inclusive Organization (HPIO) Chair

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Question Title

* 2. Please list your previous board experience and approximate dates served.

Question Title

* 3. Contact Information

Question Title

* 4. Demographic Information- Ethnicity Demographic Information is collected in order for Iowa AEYC monitor the balance of the board. Your demographics are not used to accept or decline applications.

Question Title

* 5. Demographic Information- Age

Question Title

* 6. Which of the following areas could you represent as a board member? Select all that apply.

Question Title

* 7. Why are you interested in serving as the High Performing Inclusive Organization Chair on the Iowa AEYC Governing Board? (250 words or less)

Question Title

* 8. What experiences and qualifications do you bring with you that would help elevate Iowa AEYC and support efforts to be a more inclusive organization? (250 words or less)

Question Title

* 9. I am able to meet/fulfill the requirements below.

Question Title

* 10. I agree to abide by the NAEYC Code of Ethical Conduct.

* 4. Demographic Information- Ethnicity

Demographic Information is collected in order for Iowa AEYC monitor the balance of the board. Your demographics are not used to accept or decline applications.