EmailMeForm
2018 LGBTLO Board Application
All candidates interested in applying for or renewing Officer and At-Large positions for the LGBTLO Board of Directors must complete this form by October 13, 2017. An election will be held during the LGBTLO Business Meeting at the upcoming NLC City Summit, November 15-18, 2017, in Charlotte, NC. Prospective candidates should be prepared to discuss their interest in serving on the LGBTLO Board of Directors during this meeting.
To be eligible to serve on the LGBTLO Board of Directors, the applicant must:
1. Submit this form electronically by October 13, 2017.
Please note that applications will not be accepted onsite at City Summit;
2. Be from an NLC direct or affiliate member city;
3. Be a current member of LGBTLO, with up-to-date and paid membership dues and activity fees at time of application;
4. Be actively engaged in LGBTLO;
5. If elected, attend at least two business meetings annually and participate regularly in working groups and conference calls.
Application Deadline: October 13, 2017
Part I - Personal Information
I am applying for:
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LGBTLO Officer Position
LGBTLO At-Large Position
Name:
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First
Last
Current Title:
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City or Town:
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State:
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Please select
Select state
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Is your city/town an NLC member city?
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Yes
No
I don't know
Your city/town must be a member of NLC in order for you to serve on the LGBTLO Board.
Your city's population
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Please Select a Range
Please select
under 1,000
1,001 - 2,500
2,501 - 5,000
5,001 - 10,000
10,001 - 20,000
20,001 - 30,000
30,001 - 50,000
50,001 - 100,000
100,001 - 200,000
200,001 - 300,000
300,001 - 400,000
400,001 - 500,000
500,001 - 750,000
750,001 - 1,000,000
1,000,001 - 3,000,000
3,000,001+
How long have you held your current office?
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When does your term expire?
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MM
/
DD
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YYYY
Preferred Email:
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Primary means of communicating with NLC.
Confirm Email:
Alternate Email:
This section is for an additional staff person you would like to receive copies of NLC correspondence.
Confirm Email:
Preferred Phone:
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Daytime phone number
Cell Phone:
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If your preferred daytime phone number is not your cell phone
Part II - Social Profile
The following information is optional but helpful for engagement with NLC.
Twitter Handle:
LinkedIn URL:
Facebook URL:
Part III - Demographics
The following information is optional and is requested to help ensure diversity in the NLC governance structure.
Party Affiliation:
Democrat
Republican
Non-Partisan
Independent
Other
If Other, please describe in the field below
Other:
Gender
Male
Female
Ethnicity:
African-American
American Indian
Asian/Pacific Islander
Caucasian
Hispanic
Other
If Other, please describe in the field below
Describe other:
Your Age Range:
Under 30
30-49
49-69
70+
Part IV - Biographical Sketch
Biographical Sketch:
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Please attach a brief bio (150-300 words) that includes any NLC and state municipal league leadership or service and highlights the leadership skills you would bring to the Board as an LGBTLO Officer or as a member of the LGBTLO Board of Directors.
Picture Upload
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Please attach a high-resolution photo, in jpg or png format, to be used for the website and NLC press releases.
What do you see as the two or three most important challenges facing LGBTLO and NLC in the near future upon which the LGBTLO Officers/Board of Directors should focus?
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How can you help recruit and retain LGBTLO members?
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What can you do to help LGBTLO with fundraising for future events?
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Do you have any legal or conflict of interest issues that would affect your service on the LGBTLO Board of Directors?
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