OLD Board Application

OATAG Board Application

Please complete this form to be considered for membership on the Board of OATAG

* Indicates required field

Name *

First

Last

Birth date (mm/dd/yyyy) *

Email *

Phone Number - Cell phone preferred *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Please describe your experience with gifted children/youth and/or gifted education. In lieu of completing this field, you may submit your resume/CV below.

Experience *

Please describe your strengths and potential contributions you feel you can make toward effecting Board initiatives. (for example special skills, such as communication, leadership, organization, advocacy, graphic design, computer/website, accounting, fund-raising; business partnerships and/or sponsorships for scholarships, event or meeting venues, etc.)

Strenghs *

Please describe any potential conflicts of interest. If none, please write "none."

Conflicts *

Please attach your resume, CV, Letters of reference, etc. as desired.

Attachments *

Max file size: 20MB

Are you currently the subject of an ongoing investigation related to a report of suspected child abuse or sexual conduct involving a minor child?

Criminal Behavior *

No Yes

Have you ever been convicted of any form of abuse, assault, battery, harassment, intimidation, neglect, stalking or other threatening behavior toward a child or children?

Criminal History *

No Yes

Please use this field to tell us anything else you want to about yourself or to explain any of the fields above.

Notes *

By submitting this application, you agree to the terms and conditions of board membership.

Waiver *

I Agree I Do Not Agree

Application Date (mm/dd/yyyy) *

Submit