859 Princess Street, Kingston, ON K7L 1G7 tel: 613.547.2012 fax: 613.547.2024

boarddev@klandskills.ca www.klandskills.ca

Statement of Interest for Potential Board Members

16 Bath Road Kingston, ON K7L 1C4

Tel: 613.547.2012 Fax: 613.547.2024

www.klandskills.ca boarddev@klandskills.ca

Date: ____________________

Thank you for your interest in Kingston Literacy & Skills (KL&S)! To help you determine whether KL&S is a good fit for you, please read over this form. If you are interested in further exploring Board membership, please fill in the information below and return the completed form to KL&S.

GENERAL INFORMATION:

Board members are elected at our Annual General Meeting (AGM) held in June.

Board vacancies created during the year are filled on an interim basis.

All Board members are required to sit on at least one KL&S committee.

All volunteers serving on the Board of Directors are required to provide a current Criminal Record Check at their own expense.

YOUR INTEREST: 1. Please state why you are interested in becoming a Board member of KL&S: 2. Please outline the skills, strengths and experience you would bring to the Board, or if you prefer, attach your resume: 3. Kingston Literacy & Skills’ Board of Directors is a governance board. It is not an operational board. That is, board members set policy and staff manage the day-to-day operations. Are you comfortable serving on a governance board? Yes No Comments:

859 Princess Street, Kingston, ON K7L 1G7 tel: 613.547.2012 fax: 613.547.2024

boarddev@klandskills.ca www.klandskills.ca

4. “Kingston Literacy & Skills (KL&S) furthers the development and growth of adult and family language and literacy in Kingston and neighbouring communities.” Do you view this as a mission statement that you would commit to upholding and promoting? Yes No Comments: 5. The KL&S Board meets face-to-face eight to ten times each year from September to June. Board meetings occur the last Tuesday evening of each month. Committees supporting the decision making of the Board also meet monthly. The average time commitment for serving on the KL&S Board of Directors and committees is 5—6 hours per

month. The majority of board and committee work is conducted at our main site, 16 Bath Road. Do you have the time and interest to make this commitment?

Yes No Comments: 6. Please check the knowledge/expertise/professional areas you could contribute to the KL&S Board:

Organization and Financial Monitoring Advocacy/Community Networking

Policy Review Public Speaking/Presentation

Policy Development & Writing Property Management

Charitable Status Accommodation/Real Estate/Leasing

Needs Assessment Space Planning

Risk Management Organization Structures (not-for-profit)

Accounting Strategic Planning

Budget Development Process Training: Please specify: __________________

Banking/Investments Evaluation: Please specify: ________________

Fundraising Contract/Language, Interpretation

Marketing Data Management and Interpretation

Volunteer Management Annual Report writing

Legal Matters Other: Please specify: __________________

Grant writing

16 Bath Road, Kingston, ON K7L 1C4 tel: 613.547.2012 fax: 613.547.2024

boarddev@klandskills.ca www.klandskills.ca

7. Comments or questions?

PERSONAL INFORMATION: Email: __________________________________________________________________________________

Name: __________________________________________________________________________________

Address: ________________________________________________________________________________

City: _____________________________ Province: ____________________ Postal Code: _______________

Phone (home): _________________ Phone (work): _________________ Phone (cell): _________________

Are you 18 years of age or older? Yes No

REFERENCES: Please list two people we may call who have known you for at least two years. They may be people you have worked or volunteered with, or who know personally, but they may not be family members. Name: _________________________ Relationship: _____________________ Phone: ___________________

Name: _________________________ Relationship: _____________________ Phone: ___________________

I hereby give my permission for Kingston Literacy & Skills to contact any or all of the references above, and for each person listed to release the requested personal information to authorized staff/Board member at KL&S. _______________________________ _______________________________ ________________ Applicant’s name (please print) Applicant’s signature Date

Please send us your completed form by mail, fax or email (see bottom of page). Once we receive your application, a Board member will contact you to set up an interview.