Board of Trustees Application Form
Deadline for consideration of application by the NSHS Board of Trustees Nominating Committee is August 15, 2016*
Name:
Legal Residence (house number, street name):
City: County: Congressional District:
State: Zip Code: Email address
Home phone number:_( ) Business phone number: ( )
Cell phone number: ( ) Date of Birth:
Are you a member of the NSHS? Yes No
Could you or any member of your family be affected financially by decisions made as a member of the NSHS Board of Trustees for which you have applied? Yes No
Please review the NSHS Conflict of Interest Policy at:
http://www.nebraskahistory.org/admin/board/NSHS_Code_of_Ethics_July07.pdf
Note: Trustees of the Nebraska State Historical Society must be residents of the State of Nebraska during their term of service.
Employment History (a resume or additional information is optional).
Education (resume accepted):
School: Location: Dates:
School: Location: Dates:
Areas of Interest (check all that apply):
Pioneer/Frontier History
Native American
Political/Social History
History of the 20th Century
Historic Preservation
Urban History
Rural/Agricultural History
Ethnic/Minority History
Genealogy
Other
Would you be prepared to fulfill the requirements of a three-year term?
Yes, by continuing my residence in my congressional district.
Yes, by attending the majority of four meetings per year.
Yes, by actively supporting the NSHS in words and deeds.
Why do you want to become a NSHS Trustee?_
What strengths would you bring to the board?
Additional Information: Please list additional supportive information about yourself, your experiences and background, including any board or commission you have served on in the past, honors or awards you have received, nonprofit experience and other volunteer activities.
Thank you for your interest in being a candidate for the Nebraska State Historical Society's Board of Trustees. Please provide a 200 word (or less) biography and a 200 word (or less) statement explaining why you are interested in running for the board. This will be included in the ballot mailing so that our members are provided a background of each candidate.
BIO
Statement of
Interest
*The Nebraska State Historical Society nominating committee must prepare its slate 90 days before the NSHS annual meeting, October 14, 2016. After that date additional candidates may be added to the ballot only by written petition of not less than 25 active members of NSHS.
For further information about the Nebraska State Historical Society please visit our website at www.nebraskahistory.org or give us a call at 402-471.3270 or 1.800.833.6747.
Updated 1/27/16 lmh
Please return this form to:
or mail to
PO Box 82554
Lincoln, NE 68501-2554