Board of Directors Application Contact Information Name * Name First First Last Last Organization/Coalition * Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Email Address * Phone * Job Title * County * Current Board Status Are you currently serving on the CPA Board of Directors? * Yes No Current Board Members Reflection on Past Term * Please reflect on your past two years on the CPA Board. How would you assess your participation in meetings, committees, and initiatives? What accomplishments are you most proud of, and how do you plan to contribute in the upcoming term? 0 of 250 max words Strategic Priorities * CPA’s strategic plan focuses on four priorities: Fund Development & Revenue Generation Positioning CPA as the Foremost Voice of Prevention in PA Relationship Building & Networking Enhanced Communications & Advocacy Reflecting on your board experience, how will you help advance CPA’s strategic priorities over the next term? Please provide a specific example of past work, experience, or connections that demonstrates how you could make an impact. 0 of 300 max words New Board Members Experience in Prevention * How long have you worked in the field of prevention & briefly describe your roles/responsibilities. 0 of 250 max words Strategic Priorities * CPA’s strategic plan focuses on four priorities: Fund Development & Revenue Generation Positioning CPA as the Foremost Voice of Prevention in PA Relationship Building & Networking Enhanced Communications & Advocacy Which of these priorities aligns with your strengths, and how would you contribute to advancing it? Please provide a specific example of past work, experience, or connections that demonstrates how you could make an impact. 0 of 300 max words Questions Alignment with CPA * What part of CPA’s mission or vision resonates with you, and how would you help advance it if elected? 0 of 250 max words Creating an Inclusive & Engaged Environment * How would you help CPA create a welcoming and collaborative environment that engages a diverse range of stakeholders? 0 of 250 max words Personal Goals * What are your personal goals for serving on the board? 0 of 250 max words Connections & Networks * What connections, networks, or partnerships do you bring that could help advance CPA’s mission and strategic priorities? 0 of 250 max words Experience & Expertise * Please indicate any areas where you have experience or expertise that could support CPA’s mission and strategic priorities. (Check all that apply) Accounting / Bookkeeping Finance / Financial Planning Fundraising / Development / Major Gifts Communications Advocacy / Public Policy Evaluation Legal / Compliance Human Resources Technology Artificial Intelligence Event Planning Community Engagement Coalition Building Education Youth Engagement Program or Initiative Development Prevention Science Other (please specify)Other (please specify) Time Committment * Outside of the standing board meetings (8 meetings/year, 2 hours each), how much time are you able to commit monthly to CPA activities? Past Engagement * Have you served on a CPA committee or participated in one of the following initiatives in the past two years? (Check all that apply) Advocacy Committee Conference Committee Community Access & Engagement Committee Social Media Finance Committee Membership Committee Attended the CPA Conference Use of PA Stop or PaStart Materials Participated in the Youth Summit Attended a Regional Meeting None of the above Other (please specify)Other (please specify) Acknowledgements & Agreements Commitment * Check all that apply. If elected, I will ensure my CPA membership is current (required to serve on the board). I am willing to serve a 2-year term (1/1/2026 – 12/31/2027). I am willing to serve a 1-year term (1/1/2026 – 12/31/2026). Acknowledgement: All applicants must agree to the following: I acknowledge and agree to the following: I am submitting my name for consideration as a CPA Board of Director. I am doing so with the knowledge that if elected, I will serve a 2-year term, from January 2026 – December 2027, unless I am asked to fill a vacated board seat (then the term will end on 12/31/2026). For the organization's benefit and to enhance my contributions to CPA, I agree to attend (in person or virtually) the board of director meetings, other director meetings, support the conference committee, and actively serve on at least one committee. I acknowledge that I have reviewed and accept the responsibilities expected of a CPA Board member, as described on our website. If applicable, my supervisor or board president is aware of my application submission and, if elected, supports my participation and time to be on the CPA board of directors. My application may be shared with CPA membership for voting purposes. Confirmation * I have read and accepted the acknowledgment section above, including a review of the director's responsibilities. Yes Submit Your Application If you are human, leave this field blank.
