Board Member Application

Name:

Address:

City:

State:

Zip Code:

Phone Number:

E-mail:

Name of Business:

Type of Business/Org:

Position Held:

Board Interest
Please check your area(s) of expertise:

Legal

General Business

Financial Management

Marketing

Education

Non Profit Management

Development/Fundraising

Other, please specify:

Other:

I am interested in serving on the board of

charter school or a school with the following specialization(s):

Arts Infused Curriculum

College Preparatory

Back to Basics

Individualized Curriculum

Technology Based

Internship/Career Prep

Virtual School

Other, please specify:

Other:

I have the following availability:

1 hour/month or less

2-4 hours/month

4-6 hours/month

7-10 hours/month

10+ hours/month

*Per IN law, board member participation is dependent upon successful criminal background check.