EmailMe Form - 2024 State Representative Application Form

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Contact # *

### - ### - ####

Cell Phone:

### - ### - ####

Email *

I am applying for a State Representative volunteer position in the state and/or region of:

I am an active family child care educator: *

Yes

No

Are you a current member of NAFCC? *

Yes

No

Why are you interested in serving as a State Representative of the Membership Advisory Board? *

What does leadership in family child care mean to you? What is your leadership style? *

Which skills can you bring to the advisory board from your work, education, or volunteer experience? *

If elected, how do you plan to engage with FCC, partners in Early Care and Education and allies in your state? *

Please provide a 250-word essay that will be published on the NAFCC State Representative Ballot, in first person, state why you should be elected to the position you are seeking. *

Resume *

Written recommendation #1 *

Written recommendation #2 *

Head shot photo (with a plain background) high resolution digital format *