Board Member Application

Give back by serving on the SOCIL Board of Directors.

Please print or type all information. Use the notes fields or attach additional pages if needed.

Contact Information
Consumer Control & Disability Awareness

Centers for Independent Living are created in federal law (the Rehabilitation Act of 1973). One mandate is consumer control — a majority (51%) of board members must have a disability. SOCIL uses the ADA Amendments Act of 2008 to define disability: a physical or mental impairment that substantially limits one or more major life activities; a record of such an impairment; or being regarded as having such an impairment.

Do you qualify under this requirement?
Employment
Education
High school graduated?
College graduated?
Graduate school graduated?
Additional Questions
Have you served on a board in the past?
Are you able to make a three-year commitment to the board (attend monthly meetings, periodic project meetings, etc.)?
Background
Have you been convicted of an offense other than a traffic violation (ticket)?

All board applicants will be requested to submit to a background check at SOCIL’s expense. Answers to these questions will be held in the strictest confidence by the Board. However, if it is later discovered that this application was falsified, a board member may be dismissed.

Signature
Board Narrative

Please share the following additional information with the SOCIL Board of Directors.

Feel free to use additional paper to answer these questions. Please provide the completed information to SOCIL via email at jssocil@gmail.com so the Board can review it at an upcoming meeting. Thank you for taking the time to share with us!

Email your completed application to jssocil@gmail.com, or call 740-689-1494.