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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
*
Durham
Franklin
Johnston
Orange
Wake
Phone
*
Email
*
Highest Level of Education
*
Graduate Degree
Bachelor's Degree
High School Diploma/GED
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
Yes, but prefer not to disclose
No, I don't have a significant disability
If you have a disability, how would you like to be identified?
*
Are you now or have you ever been a member of any other nonprofit Boards? If so which ones?
*
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?
*
