Assurance of Community Representation on Board of Directors

Qualification and Documentation

Assurance of Community Representation on Board of Directors

This disqualification factor applies only to applicants (as listed as the “Legal Name” of the Applicant on the SF-424) that are not tribes or Native Alaska villages:

Organizations applying for funding must show that a majority of board members are representative of the community to be served.Applicants must submit documentation that identifies each board member by name and indicates his/her affiliation or relationship to at least one of ANA’s four categories of community representation, which include: (1) members of federally or state-recognized tribes; (2) persons eligible to be a participant in, or beneficiary of, the project to be funded; (3) persons who are recognized by the eligible community to be served as having a cultural relationship with that community; or (4) persons considered to be Native American as defined in 45 CFR § 1336.10and Native American Pacific Islanders as defined in the Native American Programs Act.

Applicants that do not include this documentation will be considered non-responsive, and the application will not be considered for competition.

Board Member Name / Title on Board of Directors / Category of Community Representation
(Highlighted in Yellow)

Quick Tips for Documentation:

  1. Ensure that the full name of the board member is listed with title.
  2. Please list the board members qualification to be representative of the community to be served (eg. Member of XYZ Tribe, Pacific Islander or Alaskan Native). See highlighted above for qualifications.
  3. List the board of directors who has legal authority for the organization, including oversight of program and fiscal operations, and not an advisory committee. Recommend (not required) documenting on organization letterhead.
  4. Organizational charts, meeting minutes, and articles of incorporation may also be included.

Board of Directors:

123 Highway Rd

Anytown, ST 55555

John Clay Darlene White Eagle

President Vice President

Enrolled Member Enrolled Member

XYZ Tribe XYZ Tribe

David Long Johnathan Thunder

Treasurer Secretary

Native Hawaiian Athabascan – XYZ village

Dina Redhorse Jay Thompson

Board Member Board Member

Native – Chamorro Enrolled Member (State Recognized Tribe) ABC Tribe

Dorothy Jones

Board Member

Non Native