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Board of Director Application
I hereby apply for a seat on the Mahube-Otwa Board of Directors
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1.
I will represent the following county?
(Required.)
Becker County
Hubbard County
Mahnomen County
Otter Tail County
Wadena County
At-Large (Representing all 5 Counties)
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2.
Directors must reside in the area they represent. How long have you lived in the county above?
(Required.)
0-4 years
5-10 years
11-19 years
20+ years
3.
Are you a White Earth Tribal Member or descendant?
Yes
No
Don't know
Comment (optional)
*
4.
I am applying to be:
(Required.)
A representative of the Low-Income
A representative of the Private Sector (List Private Sector group below)
Elected Official
Private Sector Group(s) I will represent and/or position i'm elected to:
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5.
I have a background and/or expertise in the following areas:
(Required.)
Administrative/Business Management
Cultural Diversity
Chemical Health/Harm Reduction
Fiscal or Accounting
Fundraising
Early Childhood Education/Development
K-12 Education
Legal/Attorney
Marketing
Medical
Mental Health
Native American Issues
Government
Planning/Program Evaluation
Public Relations
Other (please specify)
6.
Membership in other organizations? Please list below:
7.
Brief Biography:
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8.
Address
(Required.)
Name
Home Address
Mailing Address
City/Town
Zip Code
Email Address
Cell Phone
Other Phone
9.
(Optional-Collected to build Board diversity)
Which race/ethnicity best describes you?
American Indian or Alaskan Native
Asian/Pacific Islander
Black or African American
Hispanic American
White/Caucasian
Multi-Race/Other (please specify)
