ABILITY 1ST UTAH BOARD OF DIRECTORS NOMINATION FORM If and when there is a vacancy on the Ability 1st Utah Board of Directors, I would like to be considered. I would be committed to the support and advancement of the organization’s mission. Full Name*Type your name as you would like it to appear on Ability 1st Utah’s MaterialsMailing Address*Preferred mailing address to receive mail from Ability 1st Utah. Home Phone*Work PhoneFax NumberE-mail*Which best describes you/your areas of interest: check all that apply* Person w/a Disability Family member w/a Disability Please Circle: Child Sibling Parent Other Friend w/a Disability Service Provider Advocate Financial Fundraising Legal Marketing How much time would you be able to commit to board activities?*4 to 6 hours/month7 to 9 hours/month10 or more hours/monthThe board would like its membership to provide cross-disability representation. Are you a person with a disability?*YesNoIf yes, what is your disability? (This information will remain confidential.)1. What qualifications/experience/special qualities or skills do you have that would make you an effective member of the board?*2. Briefly describe your experience with disability and/or disability issues:*3. Please list any community organizations you have belonged to and/or work with:*4. Briefly state your interest in serving on the Ability 1st UT Board*5. Please list any particular characteristics and/or skills you would bring to the Ability 1st Utah Board*6. The board would like its membership to provide cross-disability representation. Are you a person with a disability?*YesNoSignature:*Nominated by:*ATTACH RESUME AND/ OR BRIEF BIOGRAPHY* This iframe contains the logic required to handle Ajax powered Gravity Forms.