Form for Nominee | Nexus Community Partners

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

How did you hear about the BCLI? *

Who is your nominator? *

Are you currently serving on a city, county, state or Metropolitan Council board or commission? *

Yes
No

Which one? *

From the Targeted Seats List HERE, please pick up to 3 targeted boards or commissions you’d like to get on:

Targeted Board/Commission #2

Targeted Board/Commission #1

Targeted Board/Commission #3

What is your age? *

What is your gender identity? *

Other *

What is your race/ethnicity? *

Other *

Please upload your resumé *

Click or drag a file to this area to upload.

A Letter of Interest from the Applicant

This letter should indicate the nominee’s short‐term and long‐term interests both in their identified seats and any additional racial or economic equity and career aspirations. The applicant should draw on previous experiences doing advocacy work (at a personal or community level) and navigating or understanding systems to demonstrate their ability to successfully serve on a board or commission. The applicant should also speak to how they will continue to remain accountable to the community throughout their work, especially as they become an appointed commissioner.

Please upload or enter in below your interest statement

Click or drag a file to this area to upload.

Interest Statement