Board Nominee Application

Board Nominee Application

National Organization for Disorders of the Corpus Callosum

Board of Directors Nomination Application

Criteria: The National Organization for Disorders of the Corpus Callosum (NODCC) seeks professionals involved in the study of callosal disorders, professionals with certain skill sets, educators and practitioners with experience in the field of callosal disorders, and family members related to an individual with a callosal disorder to serve a three-year term on the organization’s Board of Directors. Interested nominees will be selected based upon their level of experience in their professional, community, or family life; their ability to be actively involved in board activities and responsibilities; their ability to financially contribute in the Board’s annual Give or Get commitment; their ability to attend bi-annual board meetings; and must display commendable character and dedication to the values and mission of the NODCC. Nominees are to be submitted to the organization’s Nominating Committee for evaluation; final selections are voted in by the Board of Directors.

Nominee
Last Name:
First Name:
Middle Name:
Address:
City:
State:
Zip:
Email Address:
Home Phone:
Work or Cell Phone
Nominated By
Last Name:
First Name:
Relationship with Nominee:
Address:
City:
State:
Zip Code:
Email Address:
Home Phone:
Work or Cell Phone
Suggestions for completing this form:
Follow the criteria carefully.Tab from entry area to entry area. Solicit the nominee’s help in completing the nomination form. Feel free to include any or as much information you think would be helpful to those evaluating the nominee.
Please tell us why you believe the nominee would be an appropriate board member:

Please describe nominee’s experience with callosal disorders or relationship to an individual with a callosal disorder:

What experience or talents would the nominee provide as a board member that may be of benefit to the organization:

Please describe nominee’s professional background (attach resume/curriculum vitae):

Please tell us about nominee’s community, school, church or organization involvement/activities including any board experience, committee involvement/chairmanships, recognitions, awards or special achievements:

Is nominee in a financial position to attend bi-annual meetings (ability to pay own personal travel and lodging expenses and to either personally contribute $2,000.00 to the Board’s annual Give or Get commitment or solicit those funds on his or her behalf ):

Additional comments:


Thank You

NODCC
PMB 363
18032-C Lemon Drive
Yorba Linda, CA 92886

Phone: (714) 747-0063
Fax: (714) 693-0808
Email: info@nodcc.org