HMIS Board Co-Chair Application

1.Name(Required.)
2.Organization/Agency:
3.Phone(Required.)
4.Email(Required.)
5.What is your race?(Required.)
6.What is your geographic location? (check all that apply if serving more than one) (Required.)
7.Do you have lived experience of homelessness?(Required.)
8.Please describe your experience and length of time using HMIS? (data entry, run reports, etc.) If you have not used HMIS, please enter N/A. (Required.)
9.What HMIS committees/workgroups have you served on? (please list)
10.Describe what professional skills and experience you would bring to the board?
11.In one or two sentences, describe why you are interested in this position?
12.Is there any additional information that you would like the board to know?
13.As you consider this opportunity, please familiarize yourself with the following list of expectations for board members and indicate whether you are willing to meet these expectations.
    a.  I will regularly attend board meetings.
    b.  I will actively participate in one or more standing committees.
    c.  I will stay informed on HMIS board issues, policies, and other board
         matters by reading the Governance packet information, and board packet
         materials.  
    d.  I will participate in discussions and decisions on issues, policies, and                 other board matters.
    e.  I will disclose any conflicts of interest and excuse myself from votes in
         which I have a conflict of interest
    f.  I will work in good faith with HMIS staff and other board members as
        partners towards achievement of our goals.
(Required.)
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