New Board Member Application

APPLICANT INFORMATION
Applicant’s Name*
First Last
Residence Address*
Street Address Address Line 2 City State ZIP Code
Residence Telephone #*
Résumé
Accepted file types: doc, docx, pdf, Max. file size: 128 MB.
I am seeking a seat on the Workforce Development Board representing*
- Business (includes small business)
- Labor/Workforce (includes apprenticeship programs, community-based and youth service provider organizations)
- Education/Training (includes adult education and higher education)
- Economic Development
- State Employment Service
- Vocational Rehabilitation
- Other (includes transportation, housing, public assistance and philanthropic organizations)
Business representatives: to qualify for appointment you must be an owner, CEO, COO or other individual with optimum policy making authority or hiring authority for the organization you represent; and must represent businesses that provide employment opportunities that, at a minimum, include high-quality, work-relevant training and development in in-demand industry sectors or occupations in the local area.

Non-Business representatives: to qualify for appointment, you must be an individual with policy making or decision-making authority for the organization you represent. Please refer to Attachment A for specific membership requirements.
APPLICANT INFORMATION
Job Title*
Name of Business/Employer*
Business Address*
Street Address Address Line 2 City State ZIP Code
Business Telephone #:*
FAX #*
Email*
Nature/Type of Business*
Number of employees in your business*
Major Job Classifications utilized in your business*
COMMUNITY INFORMATION
List all commissions, boards, or committees upon which you currently serve.*
Please identify any special areas of expertise and/or interests that you bring to the Board regarding economic development, business marketing, strategic planning, and/or special needs populations, including veterans, the disabled, migrant/seasonal farm workers, high risk youth, welfare recipients and/or dislocated workers.*
If you have any additional information that would be helpful in determining your nomination, please feel free to add it to this application.

Workforce Board Membership Requirements

Business

MEMBERSHIP REQUIREMENTS
Business majority who (i) are owners of businesses, chief executives or operating officers of businesses, or other business executives or employers with optimum policymaking or hiring authority; (ii) represent businesses, including small businesses, or organizations representing businesses described in this clause, that provide employment opportunities that, at a minimum, include high‐quality, work‐relevant training and development in in‐demand industry sectors or occupations in the local area; and (iii) are appointed from among individuals nominated by local business organizations and business trade associations. Must include 2 or more members that represent small business as defined by the U.S. Small Business Administration.

Labor/Workforce

MEMBERSHIP REQUIREMENTS
At least 20% representatives of the workforce within the area, who (i) shall include 2 or more representatives of labor organizations who have been nominated by local labor federations or other representatives of employees; (ii) shall include 1 representative from a joint labor‐management, or union affiliated, registered apprenticeship program within the area who must be a training director or a member of a labor organization; (iii) may include representatives of community based organizations that have demonstrated experience and expertise in addressing the employment needs of individuals with barriers to employment, including organizations that serve veterans or that provide or support competitive integrated employment for individuals with disabilities; and (iv) may include representatives of organizations that have demonstrated experience and expertise in addressing the employment, training, or education needs of eligible youth, including representatives of organizations that serve out‐of‐school youth.

Education/Training

MEMBERSHIP REQUIREMENTS
Must include: (i) 1 representative administering adult education and literacy activities under Title II; (ii) 1 representative of higher education, including community colleges; (iii) and may include representatives of local educational agencies, and of community‐ based organizations with demonstrated experience and expertise in addressing the education or training needs of individuals with barriers to employment. For (i) and (ii), representatives must be appointed from among individuals nominated by local education

Government and Economic/Community Development

MEMBERSHIP REQUIREMENTS
Must include: (i) 1 representative of economic and community development entities; (ii) 1 representative of Wagner‐Peyser programs; (iii) 1 representative of Vocational Rehabilitation programs; (iv) and may include representatives of agencies or entities administering programs serving the local area relating to transportation, housing, and public assistance; (v) and may include representatives of philanthropic organizations.

Other

MEMBERSHIP REQUIREMENTS
May include such other individuals or representative of entities as the chief elected official in the local area determines to be appropriate.