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Walden Day Care Centre

Board of Directors Application Form
Name
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Home Phone Number
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Work Phone Number
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Email Address
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Place of Employment
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May we contact you at work?


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Do you currently have children enrolled at Walden Day Care Centre?


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What site does your child attend?




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Which program does your child(ren) attend





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Do you have any previous experience on other boards?


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Please elaborate on any previous experience on other boards (i.e.: length of term, committees, highlights etc.)
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What interests you about serving on the Walden Day Care Centre Board?
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Please describe any particular areas of interest, talents or expertise which you would bring to the board?
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The WDCC Board is currently comprised of the following committees. Each Board Member is required to play an active role on at least one Committee (Please check your preference)




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For a board of this nature, confidentiallity is extremely important. Please describe what is meant by confidentiality and have you ever been in a position where issues had to be kept confidential?
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The WDCC Board meets 10 times annually with some sub-committee work in between. Would you be able to commit to attending monthly meetings on a regualr basis?


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Acceptance to the WDCC Board is contigent on receipt of a criminal reference check.
POLICY FOR CRIMINAL REFERENCE CHECK. A current (within 90 days) criminal reference check will be required to be submitted with the application to serve on the Board of Directors. The Board Chair will review the report. Any positive report relative to children's safety issues or violence will result in the applicant's automatic decline. Other issues will be reviewed on an individual basis in consultation with the Executive Director. Upon completion of the review the Chair will record receipt of the criminal reference check and return the report to the applicant.
Please provide two refernces.
Reference Name #1
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Reference Phone Number #1
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Reference Name # 2
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Reference Phone Number #2
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Comments:
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Thank you for your interest our Executive Director will be in contact with you within a week.
_______________BELOW TO BE SIGNED AND DATED IN THE OFFICE_______________
Signature
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Date
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Captcha Captcha
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