NISC Leadership Group - Public Policy

NISC Leadership Group Application - Public Policy

This form is for the Public Policy leadership position on the NISC Leadership Group. 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.

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* 1. Name and Address

Name:

Affiliated Senior Center:

City/Town:

State:

Email Address:

Phone Number:

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* 2. Why are you interested in this position?

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* 3. What is your vision for the future of senior centers, including ways to increase their visibility on policy and advocacy?

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

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

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

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* 7. What is your Senior Center location?

Urban

Suburban

Rural

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

Yes

Comments:

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* 9. What has been your NISC involvement to date, including any participation in NCOA policy discussions and advocacy activities (e.g. policy survey, Advocacy Day)?

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

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* 11. 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.

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* 12. Please describe policy and advocacy activities at the state and local levels in which you have participated, highlighting any leadership roles you have had.

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* 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.

Yes

Comments:

Thank you for your interest and application for NISC Public Policy Leadership Position.