If you have any questions, please email Cheryl J. Archibald at [email protected], or call (505) 292-2001. Board Member Nomination Form Must be 55 years old or older, an enrolled member of a federally-recognized tribe, and a current, dues paying, voting member of the National Indian Council on Aging.Sponsor(Required) Federally-recognized tribe Urban Indian Organization Elder Council Tribal Leader Title VI Director Other Name of Nominee(Required) First Last Your Email Address(Required) Your Phone(Required)NICOA Membership Number(Required) Certificate of Degree of Indian Blood Number(Required) Tribe(Required) Occupation Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code RegionVacant: Rocky Mountain, Title VI AssociationRegion You're Applying ForYour region is based on where you live, not on the location of your tribe. Alaska Eastern Great Plains Midwest Navajo Northwest Eastern Oklahoma Pacific Rocky Mountain Southern Plains Southwest Western Title VI Association Upload Resume(Required)Please highlight your experience in the fields of Native aging, health or social services, whether personal or professional. Upload your resume in .pdf, .doc or .docx format. Drop files here or Select files Accepted file types: pdf, doc, docx, Max. file size: 64 MB. Your Written StatementPlease prepare a written statement responding to the following questions: 1. What do you feel are the three most important issues facing American Indian and Alaska Native elders today?2. Describe your experiences as an advocate within your community, your state, region, or on a national basis.3. Describe your fundraising experience and what types of support and resources you bring to NICOA.4. Describe how you are connected to the elders in the area you are seeking to represent.Provide detailed examples of the networking and outreach you have done within your area. 5. Are you available to travel and represent the organization within your area at national meetings and before Congress in Washington, D.C.?Describe how you and/or the tribe/organization sponsoring you will cover your travel costs associated with serving on the NICOA Board of Director. Please list your sponsoring tribes and organizations. 6. What is your vision for NICOA’s continuing work with Native elders?Your Written Statement(Required)Or Attach As FileMax. file size: 64 MB.
