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Alliance of Disability Advocates Board Member Application
Contact Information
Name
*
First Name
Last Name
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
County
*
Beaufort
Durham
Franklin
Johnston
Orange
Pitt
Wake
Wilson
Other
Phone
*
Email
*
Verify Email
*
Preferred Method of Contact
*
Phone
Email
(The majority of our Board must have a significant disability and be willing to share it publicly)
Do you have a disability you are willing to disclose?
*
Yes, I have a disability that I am willing to disclose
No, I don't have a significant disability or I am not willing to disclose my disability
What is your disability?
*
Specific disability names are helpful but not required. Please at least describe the nature of your disability (i.e. Physically Disabled, Neurodivergent, Mentally Ill, etc.)
Are you now or have you ever been a member of any other nonprofit Boards? If so which ones?
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Please share any relevant work and/or volunteer experience especially relating to the disability community.
*
Why do you want to volunteer as a Board member with Alliance of Disability Advocates?
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