ARCH Board of Directors Application

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* 1. Contact Information

Name

Pronouns

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. What motivates you to become a board member for ARCH?

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* 3. What special qualifications and/or skills would you bring to the board?

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* 4. Please describe your past board experience (including the types of boards on which you have participated).

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* 5. Please describe your understanding of a board member’s role with ARCH

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* 6. The Board of Directors seeks a complementary balance of knowledge, skills and experience at a Governance Level. Please identify those areas in which you have basic or advanced competencies and areas you are interested in.

You may also specify if you would be interested in the position independently ("solo"), as an experienced "mentor", or someone interested in learning as a "mentee".

	Basic	Advanced	Interested, Solo	Interested, Mentor	Interested, Mentee
Business Management	Business Management Basic	Business Management Advanced	Business Management Interested, Solo	Business Management Interested, Mentor	Business Management Interested, Mentee
Community Leadership	Community Leadership Basic	Community Leadership Advanced	Community Leadership Interested, Solo	Community Leadership Interested, Mentor	Community Leadership Interested, Mentee
Education/Training	Education/Training Basic	Education/Training Advanced	Education/Training Interested, Solo	Education/Training Interested, Mentor	Education/Training Interested, Mentee
Finance/Accounting	Finance/Accounting Basic	Finance/Accounting Advanced	Finance/Accounting Interested, Solo	Finance/Accounting Interested, Mentor	Finance/Accounting Interested, Mentee
Governance and Leadership	Governance and Leadership Basic	Governance and Leadership Advanced	Governance and Leadership Interested, Solo	Governance and Leadership Interested, Mentor	Governance and Leadership Interested, Mentee
Cooperative Governance	Cooperative Governance Basic	Cooperative Governance Advanced	Cooperative Governance Interested, Solo	Cooperative Governance Interested, Mentor	Cooperative Governance Interested, Mentee
Human Resources	Human Resources Basic	Human Resources Advanced	Human Resources Interested, Solo	Human Resources Interested, Mentor	Human Resources Interested, Mentee
Fundraising	Fundraising Basic	Fundraising Advanced	Fundraising Interested, Solo	Fundraising Interested, Mentor	Fundraising Interested, Mentee
Government/Political Acumen	Government/Political Acumen Basic	Government/Political Acumen Advanced	Government/Political Acumen Interested, Solo	Government/Political Acumen Interested, Mentor	Government/Political Acumen Interested, Mentee
Coalition Building/Activism	Coalition Building/Activism Basic	Coalition Building/Activism Advanced	Coalition Building/Activism Interested, Solo	Coalition Building/Activism Interested, Mentor	Coalition Building/Activism Interested, Mentee
Healthcare Administration/Policy	Healthcare Administration/Policy Basic	Healthcare Administration/Policy Advanced	Healthcare Administration/Policy Interested, Solo	Healthcare Administration/Policy Interested, Mentor	Healthcare Administration/Policy Interested, Mentee
Event Planning	Event Planning Basic	Event Planning Advanced	Event Planning Interested, Solo	Event Planning Interested, Mentor	Event Planning Interested, Mentee
Legal	Legal Basic	Legal Advanced	Legal Interested, Solo	Legal Interested, Mentor	Legal Interested, Mentee
Real Estate/Property Management	Real Estate/Property Management Basic	Real Estate/Property Management Advanced	Real Estate/Property Management Interested, Solo	Real Estate/Property Management Interested, Mentor	Real Estate/Property Management Interested, Mentee
Public Relations/Communications	Public Relations/Communications Basic	Public Relations/Communications Advanced	Public Relations/Communications Interested, Solo	Public Relations/Communications Interested, Mentor	Public Relations/Communications Interested, Mentee
Quality/Risk Management	Quality/Risk Management Basic	Quality/Risk Management Advanced	Quality/Risk Management Interested, Solo	Quality/Risk Management Interested, Mentor	Quality/Risk Management Interested, Mentee
Strategic Planning	Strategic Planning Basic	Strategic Planning Advanced	Strategic Planning Interested, Solo	Strategic Planning Interested, Mentor	Strategic Planning Interested, Mentee
Other (please specify):	Other (please specify): Basic	Other (please specify): Advanced	Other (please specify): Interested, Solo	Other (please specify): Interested, Mentor	Other (please specify): Interested, Mentee

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* 7. Would you be interested in joining one of the Board’s committees?

	Yes	No
Finance Committee	Finance Committee Yes	Finance Committee No
Governance Committee	Governance Committee Yes	Governance Committee No
Fundraising Committee	Fundraising Committee Yes	Fundraising Committee No
Anti-Oppression Committee	Anti-Oppression Committee Yes	Anti-Oppression Committee No

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* 8. At HIV/AIDS Resources and Community Health (ARCH), we dream of a time and place where everyone is free to live healthy, stigma-free, vital lives.

We provide anti-oppressive, sex-positive, inclusive care, treatment and prevention services in the area of HIV/AIDS and other sexually transmitted blood-borne infections through innovative health promotion strategies and community engagement.

Can you commit to working within and upholding the following ARCH values:

	Yes, Agree	Yes, Strongly Agree	Decline to Answer
Greater and more Meaningful Engagement of People who live with HIV/AIDS	Greater and more Meaningful Engagement of People who live with HIV/AIDS Yes, Agree	Greater and more Meaningful Engagement of People who live with HIV/AIDS Yes, Strongly Agree	Greater and more Meaningful Engagement of People who live with HIV/AIDS Decline to Answer
Trans Affirming	Trans Affirming Yes, Agree	Trans Affirming Yes, Strongly Agree	Trans Affirming Decline to Answer
Harm Reduction-Based	Harm Reduction-Based Yes, Agree	Harm Reduction-Based Yes, Strongly Agree	Harm Reduction-Based Decline to Answer
Anti-Oppressive	Anti-Oppressive Yes, Agree	Anti-Oppressive Yes, Strongly Agree	Anti-Oppressive Decline to Answer
Inclusive	Inclusive Yes, Agree	Inclusive Yes, Strongly Agree	Inclusive Decline to Answer
Respectful	Respectful Yes, Agree	Respectful Yes, Strongly Agree	Respectful Decline to Answer
Caring	Caring Yes, Agree	Caring Yes, Strongly Agree	Caring Decline to Answer
Accepting	Accepting Yes, Agree	Accepting Yes, Strongly Agree	Accepting Decline to Answer
Passionate and Committed	Passionate and Committed Yes, Agree	Passionate and Committed Yes, Strongly Agree	Passionate and Committed Decline to Answer
Accountable	Accountable Yes, Agree	Accountable Yes, Strongly Agree	Accountable Decline to Answer
Accessible	Accessible Yes, Agree	Accessible Yes, Strongly Agree	Accessible Decline to Answer
Sex-Positive	Sex-Positive Yes, Agree	Sex-Positive Yes, Strongly Agree	Sex-Positive Decline to Answer
Client-Centered	Client-Centered Yes, Agree	Client-Centered Yes, Strongly Agree	Client-Centered Decline to Answer
Evidence-Based	Evidence-Based Yes, Agree	Evidence-Based Yes, Strongly Agree	Evidence-Based Decline to Answer
Strength-Based	Strength-Based Yes, Agree	Strength-Based Yes, Strongly Agree	Strength-Based Decline to Answer
Self-Determination	Self-Determination Yes, Agree	Self-Determination Yes, Strongly Agree	Self-Determination Decline to Answer
Flexible	Flexible Yes, Agree	Flexible Yes, Strongly Agree	Flexible Decline to Answer

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* 9. Please provide two references that are familiar with your previous board or committee experience:

1st Reference:

Relationship:

Phone:

Email:

2nd Reference:

Relationship:

Phone:

Email:

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* 10. Please attach a current resume to your application.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 11. By submitting this application and a resume, I declare that:

I meet the eligibility criteria and accept the conditions of nomination as delineated.

I certify that the information in this application and in my resume is accurate and true.

I understand that the establishment of the Board of Directors for this non-profit corporation complies with the Bylaws of the Organization. I also understand that acceptance as a board member includes joining the Membership of the Organization.

I understand and agree

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* 12. What is your weekly availability for meetings/training sessions?

	Evenings, 5:30 - 7:30pm	Evenings, 7:00 - 9:00pm	Unavailable
Monday	Monday Evenings, 5:30 - 7:30pm	Monday Evenings, 7:00 - 9:00pm	Monday Unavailable
Tuesday	Tuesday Evenings, 5:30 - 7:30pm	Tuesday Evenings, 7:00 - 9:00pm	Tuesday Unavailable
Wednesday	Wednesday Evenings, 5:30 - 7:30pm	Wednesday Evenings, 7:00 - 9:00pm	Wednesday Unavailable
Thursday	Thursday Evenings, 5:30 - 7:30pm	Thursday Evenings, 7:00 - 9:00pm	Thursday Unavailable
Friday	Friday Evenings, 5:30 - 7:30pm	Friday Evenings, 7:00 - 9:00pm	Friday Unavailable
Saturday	Saturday Evenings, 5:30 - 7:30pm	Saturday Evenings, 7:00 - 9:00pm	Saturday Unavailable
Sunday	Sunday Evenings, 5:30 - 7:30pm	Sunday Evenings, 7:00 - 9:00pm	Sunday Unavailable

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* 13. ARCH has prioritized a number of seats for individuals from the populations that we serve most. If you feel comfortable, please select which, if any, of the following you personally identify with

Person living with HIV

Transgender and/or Two Spirit Person

Gay, Bi, and/or Queer Man

Non-binary, Genderqueer, Genderfluid Person

Person with a history of substance use

African, Caribbean, and/or Black Person

Person living with Hep C

Person impacted by HIV