BOARD APPLICATION First Name:  * Last Name:  * Email Address: Address:  * City - State - ZIP:  * County Phone 1:  * Phone 2: Employer: Are you related to anyone employed at CC Idaho? Yes No   Region looking to represent: West Region Central Region East Region   BOARD MEMBER DEFINITION CC Idaho has a 14 member tripartite Board of Trustees 1/3 of its members must be in each of the following categories which one are you eligible to fill?:   (1) PUBLIC SECTOR - 1/3 of the Board are elected public officials holding office on the date of selection or their representatives employed in state or federal agencies on school boards: I am a current elected public official Name of Office & Term I am a representative of: Name of Official - Office & Term I am currently employed at: State or Federal Agency I am currently on the school board at: Name of School   (2) LOW INCOME SECTOR - 1/3 of the members are low income or are representative of low-income individuals and families in the neighborhood served or are current or former parents of our MSHS children. Qualified under this category: Select BelowI am a migrant or seasonal farmworkerMy income does not exceed current poverty guidelinesI live in a low-income neighborhoodI'm a current or former parent of children who are enrolled or were formerly enrolled in Head Start   (3) PROFESSIONAL SECTOR: 1/3 of the board members are official members of business - industry - labor - religous - law enforcement - education or other major group and interests in the community served with preference given in the categories below: Expertise in Early Childhood Education Expertise in Workforce Development Expertise in Fiscal Management/Accounting Expertise in Medical/Health Licensed Attorney Expertise in Housing/HUD/Rural Development Other Area of Expertise -   BUSINESS - PROFESSION OR EMPLOYMENT Briefly describe your place of business - or place of employment. Tell what - if any - the relationship of your business or professional involvement is with regard to farmworkers and low-income people.   PERSONAL INFORMATION Please provide a brief synopsis about yourself - your background - etc..... So that the committee can gain a feeling of who you are - what your experiences have been. You might include such details as your family background - your educational experiences - any previous experience with Community Council of Idaho or other programs for low-income people.   PARTICIPATION IN OTHER BOARDS: Describe: Name of Organization - Area Served - Purpose or kind of services provided Describe: Name of Organization - Area Served - Purpose or kind of services provided Describe: Name of Organization - Area Served - Purpose or kind of services provided   CC Idaho Board Meetings are scheduled at a minimum four times a year in Caldwell Twin Falls or Idaho Falls. Will you attend regularly scheduled Board Meetings? Yes No   Will you offer services & expertise as needed at times other than Board Meetings? Yes No   Why would you like to serve on Community Council of Idaho's Board?   Please write a brief statement of your understanding of the mission of Community Council of Idaho.   Please summarize the education skills & expertise you will bring to CC Idaho.   Criminal Background Investigation After submitting this form a member of the CC Idaho staff will contact you so that you may submit written authorization for CC Idaho to conduct a criminal background check. Your application will not be considered until this approval has been given. Please enter "YES" below if you agree to participate in a criminal background check. Security code:   * Do not enter anything in this field: