Please provide your contact information via each question below.
Full Name (First and Last) *
Your answer
Email Address *
Your answer
Re-Enter Email Address *
Your answer
Cell Phone Number *
Your answer
Home Address (Number and Street) *
Your answer
Home Address (City or Town) *
Your answer
Home Address (State) *
Your answer
Home Address (Zip Code) *
Your answer
Professional Background & Experience
Please provide details regarding your professional experience via each question below.
Current Position *
Your answer
Professional Title *
Your answer
Credentials & Licensing *
Your answer
Place of Employment *
Your answer
Employer City *
Your answer
Employer State *
Your answer
Please provide the full name and email address of one professional reference. *
Your answer
Please provide a brief personal bio. *
Your answer
Briefly describe your professional experience in relation to the practice of school social work. *
Your answer
Why do you wish to be considered for an ACSSW Board Member position? *
Your answer
Briefly describe your past and/or current experience serving on a Board of Directors. *
Your answer
Of the following - which are your strengths, talents and interests? Check all that apply. *
Required
How will you apply your skills to support & enhance the work of the Board and the profession of SSW? *
Your answer
What are you doing now that could strengthen the work of the ACSSW Board and the SSW profession? *
Your answer
Does your schedule permit you to fully participate in ACSSW's 2 hour monthly Board teleconferences? *
Are you able to commit up to 10 hrs/month working on ACSSW Board activities including meetings? *
Does your schedule permit you to travel to attend in-person Board meetings? *
Are you able to commit to being a Board member for two full years? *
ACSSW is a working Board with several committees and Thematic Groups. In which two would you be most interested? *
Required
ACSSW has tasks that need commitment and dedication. To which can you bring your talents? *
Required
Does your employer support your membership and participation as an ACSSW Board Member? *
Do you presently serve on any professional Boards or committees? *
If you presently serve on any professional Boards or committees, please indicate which ones.
Your answer
I have read and understand the info packet and attest that I am able to complete the requirements. *
Is there anything else you would like to share with the Board Member Search Committee?
Your answer
What questions, if any, do you have about serving as a member of the ACSSW Board of Directors?
Your answer
Please email your resume/CV to Board Member Stacy Gherardi at sgherard@nmsu.edu as soon as you submit this form. Your application will not be complete without this additional step.