State Public Charter School Authority Board Member Application

State Public Charter School Authority

Board Member Application

Apply by Tuesday, May 28, 2024

First Name:*

Middle Name:

Last Name:*

Are you know, or prefer, any other aliases?*

What is your date of birth?*

Ethnicity: *

Are you a U.S. Citizen? *

Select

Are you a naturalized U.S citizen?*

Select

If yes, what is the date of your naturalization?

If yes, what is your place of birth?*

Select or enter value

Are you a veteran?*

Select

Are you registered to vote?*

Select

Are you a registered lobbyist?*

Select

What is your mailing address?*

Email:*

Primary phone: *

Alternative phone:

County of residence:*

Resident since:*

Who is your curent employer?*

Employer address:*

Job Title:*

Any specialized licensing? If so, please list here*

Select or enter value

What is your highest completed education level:*

If appointed, would this position cause a conflict*

Select or enter value

What personal and leadership qualities/experiences*

If yes, please list all state offices served in:*

Select or enter value

Resume and Personal Statement*

Please provide us with your resume and a personal statement regarding why you would like to serve on the SPCSA Board.

Drag and drop files here or

Do you understand your application will be received for the appointment of the State Public Charter School and NOT the State Board of Education?*

Send me a copy of my responses