NISC Executive Committee Application

This form is for leadership positions on the NISC Executive Committee. The information collected will be used to assess a person's areas of knowledge and experience that would qualify them for the position.

Applicants are also required to fill out an NISC Interest and Expertise Inventory.

* 1. Name and Address

* 2. Position applying for

* 3. Why are you interested in this position?

* 4. What is your vision for the future of senior centers?

* 5. What is your length of time in the field of aging?

* 6. What is your length of time working in Senior Centers?

* 7. What is your current position in agency/ organization and length of time?

* 8. What is your Senior Center location?

* 9. Is the Senior Center currently NISC Nationally Accredited?

* 10. What has been your NISC involvement to date?

* 11. Please describe leadership positions you have held, include organization, position and dates.

* 12. Please list people who've worked with you in your leadership positions. Please include the name, organization, phone number and email address of three individuals.

* 13. Will you be able to devote the required time to this position? Leadership positions require attendance at one monthly conference call, including preparation time. Based on the role chosen you will have other related tasks. You are also required to attend one in person meeting per year.

Thank you for your interest and application for a NISC Leadership Position.