Skip to main content
Dillard Academy
Main Menu Toggle
About Us
Vision/Mission
Education
Policies
Photo Gallery
Athletics
Transportation
Nutrition
Parents
Parent Information
Parent Handbook
RTA (read to achieve)
Garrets Law
EC Child Find
Homebase Parent Portal
PTO - Parent Teacher Organization
Parent Compact
Calendar
Parent Engagement
Technology Policies
Careers
Employment
Administration
Founder
Board of Directors
Application for Board Membership
Executive Director
Director Of Curriculum and Instruction
Co Principals
Dean of Students
Administrative Assistant
Academics
Academic Resources
Academic Websites
NC Digital Children Reading Initiative
Technology Policy
DA Classroom Teachers
Enrollment
Enrollment
Contact Us
Our Information
Contact Information Change Form
Facilities Work Order
Tech Work Order
Staff Directory
Search
Search
Search
Header Button
Social Media Links
Facebook
Instagram
Loading...
Editing previous response:
Please fix the highlighted areas below before submitting.
Application for Board Membership
Application for Board Membership
First Name
*
Answer required for "First Name"
Last Name
*
Answer required for "Last Name"
Date of Birth
*
MM/DD/YYY
Answer required for "Date of Birth"
Address
*
Where you reside. Include City and State
Answer required for "Address"
If less than 7 years, please list all address in the last 7 years
*
Answer required for "If less than 7 years, please list all address in the last 7 years"
Email Address
*
Answer required for "Email Address"
Phone Number
*
Number Required
Highest level of education completed
*
Answer required for "Highest level of education completed"
Name and address if HS/College
*
Must hold at least a high school diploma or its equivalent - college, BA or BS, community college, AA, etc.
Answer required for "Name and address if HS/College"
Please list three (3) references who can verify your personal/professional background.
*
Reference 1
Answer required for "Please list three (3) references who can verify your personal/professional background."
Please list three (3) references who can verify your personal/professional background.
*
Personal Reference 2
Answer required for "Please list three (3) references who can verify your personal/professional background."
Please list three (3) references who can verify your personal/professional background.
*
Reference 3
Answer required for "Please list three (3) references who can verify your personal/professional background."
Please Write a statement as to your personal reasons for wanting to serve on the Board of Directors of Dillard Academy Charter School.
*
Answer required for "Please Write a statement as to your personal reasons for wanting to serve on the Board of Directors of Dillard Academy Charter School."
Please make a statement of personal/professional background, including any talents or expertise that can contribute to the function of the corporate board.
*
Answer required for "Please make a statement of personal/professional background, including any talents or expertise that can contribute to the function of the corporate board."
Resume
Answer required for "Resume"
Choose a file
or drag it here.
Signature
*
Signature Required
Sign this form
By pressing “Sign Form,” you are agreeing to signing this form electronically.
Type
Draw
Signature
*
Type to sign
Draw your signature
×
Clear signature
Full Name
*
Date:
Confirmation Email
Confirmation Email
*
Answer required for "Confirmation Email"
