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Candidate Application

Loving Hearts Animal Society
Board of Directors & Board Advisory Council

candidate APPLICATION

The Loving Hearts Animal Society operates a nonprofit, no-kill facility dedicated to the rescue and adoption of homeless cats and dogs in East Texas. The information requested in this application is required to determine your experience and qualifications to serve as a member of our organization. Upon review of your application, the President or a member of the Board Governance Committee will be in contact to schedule an interview appointment. A decision regarding your application will generally be given within 7-10 days after your interview.

Please complete all fields as accurately as possible, using "N/A" or "None" for any questions that do not apply to you unless otherwise directed.

Appointment Type (Select One)

Board of Directors Board Advisory Council

Area of Expertise (Select One)

If Other, Please Specify

Part I. Personal Information

Title

First Name

Last Name

Credentials

Home Address/PO Box

Suite/Apt. No.

Telephone

City

State

Zip Code

County

Email

Birthdate

Driver License/State Issued ID No.

Vehicle Make & Model

Vehicle LIcense Plate No.

Upload Your CV (Optional)

If a CV has been uploaded, skip to Part III.

Part II. Employment & Education

Current Employer

Position

Address/PO Box

Suite/Office No.

Telephone

City

State

County

Zip Code

Email

Past Employment History

Educational Background

Special Skills

Part III. Relevant Experience

Board Experience

Are you currently serving on any other boards or committees?

Yes No

If so, please specify which boards or committees, your role and/or duties:

Have you served in the past on any other boards or committees?

Yes No

If so, please specify which boards or committees, your role and/or duties:

Community Service

Apart from board related roles, are you currently a volunteer for any groups or organizations?

Yes No

If so, please specify which groups or organizations, your role and/or duties:

Apart from board related roles, have you volunteered in the past for any groups or organizations?

Yes No

If so, please specify which groups or organizations, your role and/or duties:

Part IV. Affiliations

Professional Affiliations
Use CTRL+CLICK to make multiple sections, repeat to unselect.

Select any counties in which you have strong ties with community/business leaders, animal welfare organizations, or academic institutions:

Charitable Affiliations

Please list any charitable, political or religious organizations with which you are affiliated:

Part V. Criminal & Disciplinary Background

Have you ever been convicted of a felony or misdemeanor (excluding traffic violations)?

Yes No

If yes, please explain:

Do you currently have any open complaints or disciplinary actions pending?

Yes No

If yes, please explain:

Have you ever been disciplined by any licensing board or professional/civic organization?

Yes No

If yes, please explain:

Part VI. Interview Essay

Please explain why you are interested in our organization and serving as a member of the board or advisory council:

Part VII. References

Please provide two personal or professional references not related to you that may be contacted to verify your application information and qualifications.

Name

Telephone

Relationship

Name

Telephone

Relationship

We appreciate your interest in serving as a member of our organization and taking the time to complete an application.

Shelter, Adoption and Rescue Center

HOURS OF OPERATION

Monday - Saturday 9:00 am - 5:00 pm

Emergency Services 24/7 Including Holidays

NEWSLETTER SUBSCRIPTION

First Name

Last Name

Email Address

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THANK YOU

for submitting an application

a member of our organization will be in contact soon

THANK YOU

for subscribing to our mailing list

An annual newsletter and periodic information about our organization will be emailed to our subscribers.

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