Board of Directors Nomination Form Question Title * 1. Are you currently a KCSEA member? Yes No Question Title * 2. What is your name? Question Title * 3. What is your work title? Question Title * 4. What agency/company/organization are you employed by? Question Title * 5. What is your address? Question Title * 6. What city/town do your reside in? Question Title * 7. What state do you reside in? Question Title * 8. What is your zip code? Question Title * 9. What is your email address? Question Title * 10. What is your phone number? Question Title * 11. How long have you been in your current position? Question Title * 12. Provide a description of your job as it relates to child support. Include prior experience/employment. Question Title * 13. Do you have previous experience with KCSEA as a director, officer, committee chair/co-chair or committee member? Question Title * 14. Do you have the approval/support of your supervisor or manager for the commitment required to be a Board of Director? (Four in-person meetings a year in Topeka approximately 3 – 4 hours each and a monthly virtual meeting approximately one hour each. These do not include committee meetings and/or committee work.) Yes No Question Title * 15. List other volunteer positions you have held, including your role and name of the organization. Question Title * 16. Are there special ideas and/or issues you want to bring to the KCSEA leadership? Question Title * 17. What contributions or skills do you feel you can bring to the KCSEA Board as a Director? Done