LDA Board of Directors Nominations Please complete and submit this questionnaire no later than September 30, 2021. If you have any questions, please email Nina DelPrato at email@example.com for assistance.Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Enter Email Confirm Email Phone*ROLE OF LDA IN THE FIELD OF LEARNING DISABILITIESWhat do you think are the three most critical issues facing the field of learning disabilities today? Briefly comment on the issues and give an approach LDA could use to address each one.*QUALIFICATIONS AND ORGANIZATIONAL ACTIVITIESWhy are you interested in serving on the LDA Board of Directors?*What are your major areas of interest in learning disabilities or LDA?*What strengths, skills and/or talents would you bring to LDA?*Please list positions you have held on any Board of Directors/Executive Committee, and Working Committees (fundraising, membership, advocacy, policy, etc.) Please list the dates you served, and your accomplishments/contributions during this time period:*Are you a current or past member of your LDA state/local affiliate? If so, please list involvement with your LDA state/local affiliates:*MEMBERSHIP/AFFILIATE SUPPORTHow would you address membership retention? What ideas can you suggest to increase membership?*EXPECTATIONS OF OFFICERS AND BOARD MEMBERSServing on the LDA Board of Directors or as an officer will require a commitment of time and effort. There is the requirement to be on two working committees and to attend at least two bi-annual board meetings. Are you willing to make that commitment?* Yes No With which committee(s) do your talents/interests best align?* Select All Education Public Policy / Advocacy State Affiliate / Membership Development Adult Topics Finance Mental Health Bylaws Nominating Conference The LDA Board of Directors or officers may not use the office for personal gain? Will you have any conflicts of interests in this regard?* Yes No Candidate Agreement* I agree to the expectation as stated below.Board members are expected to give or raise an annual gift of $250.00. Give or Raise examples include personal contributions, Facebook fundraiser, Giving Day, etc. When LDA is applying for grants, a usual criterion is 100% Board participation in financially supporting their nonprofit organization. ADDITIONAL COMMENTSPlease share additional information that you feel will be helpful to the committee:*OPTIONAL DEMOGRAPHIC INFORMATIONWhat gender do you identify with? Male Female Non-binary, 3rd gender Prefer not to say What age range do you fall into? Under 25 25 - 34 35 - 44 45 - 54 55 - 64 65 or over Prefer not to say How would you describe your race? American Indian or Alaska Native Asian Black or African American White Native Hawaiian or Pacific Islander Prefer not to say How would you describe your ethnicity? Hispanic / Latino Multi-racial Prefer not to say Thank you for sharing this information with us. We look forward to visiting with you by telephone during our interview meeting and will contact you soon to determine a convenient time.