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Please complete the application to be considered for the board development committee to evaluate as a part of the application process. Your responses will be shared with the CISNT board of directors. If you have any questions, please email Dana Smith.

Board Member Application

Name*
First Last
Mobile Phone*
Work Phone
Home Address*
Street Address Address Line 2 City State ZIP Code
Business Name*
Occupation/Position:*
Business Address*
Street Address Address Line 2 City State ZIP Code
Email*
Enter Email Confirm Email
Birth date*
MM slash DD slash YYYY

By agreeing to serve on the board of directors, you authorize CISNT to use the personal information collected on this board member application, including your birth date, to run your criminal background check. I understand that the results of the background check can impact my standing as a board member.
Are you a Member or Director of any Business, Professional, Civic, Charitable, Social or Fraternal Organizations? If so please list below.*
Why would you like to be on Communities In Schools of North Texas’ Board of Directors?*
Briefly describe your professional experience and expertise that would be beneficial to CISNT*
CISNT pursues grants throughout the year that require 100% board member participation in personal giving to the organization (the amount does not matter, only the participation). Would you be willing to personally participate in financially supporting CISNT?*
Please provide two references (with phone and/or email contact information).*
Do you have any questions about Communities In Schools or Board of Director responsibilities?*