2023-24 ASC Board Application

Application Instructions

Please complete the Candidate Overview, Candidate Reference, and Candidate Narrative questions. You may also attach a resume in support of your application.

Applications must be received by 5:00 pm ET on Friday, May 19, 2023.

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* 1. Candidate Name

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* 2. Title

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* 3. Organization

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* 4. Contact Information

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 5. State Commission

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* 6. Years Affiliated with State Commission

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* 7. Candidate Type (choose one)

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* 8. Commissioner Leadership Positions (Commissioners Only)

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* 9. ASC Committee Interest

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* 10. Candidate Reference (should be a state commission staff member or commissioner)

Name

Title

Organization

E-mail address

Phone number

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* 11. Describe the length and depth of your affiliation with your state service commission. For staff members: length of employment, positions held, and other relevant professional experience. For commissioners: length of appointment, leadership positions held, and other relevant professional experience. If applying as an at-large Board member, please describe your experience interfacing with state service commissions and relevant professional experience.

Note for Youth Commissioner Candidates — Candidates for the Youth Commissioner position must have a letter of reference from the executive director of their respective commission. This letter must include a commitment from the executive director to cost-share travel expenses for the Youth Commissioner to participate in ASC Board activities.

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* 12. Age

Prefer not to answer

18-24

25-34

35-44

45-54

55-64

65+

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* 13. Race/Ethnicity

Prefer Not to Answer

Black or African American

American Indian or Alaska Native

Asian or Asian American

Native Hawaiian or other Pacific Islander

Hispanic or Latino

White

Other (please specify)

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* 14. Sex

Prefer not to answer

Female

Male

Intersex

Other (please specify)

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* 15. Gender

Prefer not to answer

Cis woman

Cis man

Trans woman

Trans man

Genderfluid

Genderqueer

Agender

Nonbinary

Other (please specify)

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* 16. Sexual Orientation

Prefer not to answer

Asexual (not sexually attracted to others)

Aromantic (not romantically attracted to others)

Bisexual (attracted to any sex)

Heterosexual (attracted to people of another sex or gender)

Homosexual (attracted to people of the same sex or gender)

Pansexual (attracted to people of all genders, or regardless of gender)

Queer (variety of definitions)

Other (please specify)

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* 17. Disability

Prefer not to answer

Intellectual

Physical

Mental health

Sensory

Other (please specify)

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* 18. Religion or Religious Philosophy

Prefer not to answer

Buddhist

Christian (Catholic, Protestant, or any other Christian denominations)

Hindu

Jewish

Muslim

Sikh

No religion

Other (please specify)

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* 19. Why are you interested in serving as a member of the ASC Board of Directors?

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* 20. What unique skills or abilities would your membership bring to the ASC Board of Directors, including relevant experience in communications, finance/administration, grants management, JEDI (Justice, Equity, Diversity, and Inclusion), legal, public policy, and/or resource development?

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* 21. ASC actively strives to embody inclusive leadership behaviors and traits in all personal and professional interactions. What background, experience, and perspective could you bring to our goal of inclusive leadership?

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* 22. Resume (optional)

PDF, DOCX, DOC file types only.

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Thank you for your interest in serving on the ASC Board of Directors!