Board of Directors Nomination Application and Materials | Page 3

The Arc of Maryland Nomination for Board of Directors Please forward this application to: The Arc Maryland c/o Nominating Committee PO Box 1747 Annapolis, Maryland 21401 Or email to [email protected] with subject line: Nominations. 1. Your Contact Information Name: Address: County: Telephone: Email Address: Are you a member of a local chapter of The Arc? __ Yes If “Yes,” what is the name of the local chapter? 2. __ No How would you describe yourself – please check all that apply: __ I am a person with intellectual and developmental disabilities. __ I am a family member of a person with intellectual and developmental disabilities. Please state your relationship – mother, brother, etc. and the age of your family member with intellectual and/or developmental disabilities. __ I am a professional in the field of developmental disabilities. Please state your discipline, position, or other descriptive information. __ I am a concerned citizen and wish to contribute my time and talents. 3. Please indicate your professional background and expertise, such as Accounting, Attorney, Fundraising, Marketing, Medical, Financial, Self Advocacy, etc. 4. Please indicate your top 5 priorities in the following list: (Rate from 1-5 with 1 being the most interested.) __ __ __ __ Education/Special Education Early Intervention Children’s Issues Legal Advocacy __ __ __ __ Housing Transportation Employment Health and Medical Care