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Personal Information ( * - Required Field)     *First Name *Last Name *Email: *Street Address: *City: *State: *Zip Code: *Home Phone: Work Phone: Referred By:       Professional Background     *What is your professional and educational background?       What other organizations and/or committees are you involved with in Orange County?       References     Name: Company: Phone: Name: Company: Phone:       Our Mission     Project Independence’s mission is to promote civil rights for people with developmental disabilities through services which expand independence and choice.  Project Independence is Orange County’s only one-stop provider of programs offering adult clients with developmental disabilities seamless solutions in their housing, social, leisure and working lives.   Our Vision Our Vision is of a society that values each individual and provides the opportunity for all people to lead full and productive lives; Looking beyond disabilities, focusing on capabilities, expanding possibilities.   Our Values We are committed to providing the highest quality services to people with disabilities, and to advocate on their behalf, so that they may realize their full potential. Our strength is the result of the team effort of our volunteers, our employees, our donors, our program participants and society in general. We take pride in conducting the business of Project Independence with integrity, practicing the highest ethical standards.   *Please write a brief statement describing your skills and how they can be used to support Project Independence's mission.   What Project Independence committees would you be interested in? 1st Choice: Capital Campaign Finance Committee Marketing Committee Program Committee Recruitment Committee Special Events Committee 2nd Choice: Capital Campaign Finance Committee Marketing Committee Program Committee Recruitment Committee Special Events Committee   Board Responsibilities Be an advocate for the organization in the community. Be familiar with and willing to perform my legal and fiduciary duties, as described in the regulations for nonprofits in the State of California. Support the organization with charitable gifts at an appropriate level Be an ambassador for the organization and participate in the development of relationships with prospective and current donors that will lead to a strengthening of their support for and investment in our organization. Be an asker when appropriate and to participate in fundraising activities, events and solicitations as assigned and as appropriate. Work cooperatively and creatively with other board members and staff members in the advancement of the mission and vision of the organization. Understand, promote and reflect the organization’s values. Attend board meetings on a regular basis, including any retreats Stay connected with the organization’s work between board meetings as required or requested. Serve actively on at least one board committee Be loyal to the organization in times of crisis Provide honest, open and candid feedback to staff and other board members Provide insights and perspective unique to the communities I represent Participate in the organization’s strategic planning process. Avoid even the appearance of a conflict of interest, and disclose any possible conflicts to the board chair. Make a minimum two-year commitment to serve on the board. Meet once each year with the Board Chair and Executive Director to discuss my experience as a board member   Conflict of Interest Disclosure I have no conflict of interest to report I have the following conflict of interest to report     Please enter the code above:  [ Different Image ]