Board Membership Application Name* First Last Email* Phone*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Company / Affiliation Title Your City Council District (home and/or work) In which sector(s) of the food system do you have expertise? Please check all that apply.* Growing Processing Transportation & Storage Distribution Eating & Celebration Waste Recovery Education Other, please specify Other How and when did you learn about FPCSA?*What has been your involvement with our workgroups?*About how much time could you devote per month, apart from meetings, to workgroup business, research, or other efforts?*Why would you like to be a board member of FPCSA?*Why do you believe you would make a good FPCSA board member? Please describe the skills, experience, and other strengths you will bring to the board. Include administrative, website, and other skills, if any.*What is your affiliation to the San Antonio area’s food system?*What is your vision for the San Antonio food system? How might we achieve that vision?*What will be some of the opportunities and challenges to achieving a sustainable and accessible food system?*Membership on the Council will require attending at least 80% of all meetings of the full council with necessary preparation done in advance and to participate in committee work. Will you be able to make this time commitment?* Yes No Board members are selected based on their skills, experience, and commitment to improving the San Antonio area food system, and are asked to serve in the public interest, rather than to directly represent any organization they are affiliated with. If seated on the council, will you be able to serve in the public interest, and recuse yourself from voting on topics if you have a conflict of interest?* Yes No If selected, do you have permission from your agency to use your title and affiliation?* Yes No Would your professional affiliation prevent you from taking part in votes or signing policies or other documents of the FPCSA? (Answering yes will not disqualify you from serving on the board.)* Yes No Not sure Δ
