Board of Ed Datasheet
Thank you for your interest in serving on the Geneva CSD Board of Education. Please note, this form does not constitute application for candidacy, which must be duly filed with the Geneva CSD district clerk at District Office, 400 West North Street, Geneva, NY 14456. The information provided here will be used to notify the public of your candidacy should you file the appropriate application/signatures.
Geneva CSD Board of Education Candidate Datasheet
1.
Name:
*
2.
Telephone Number:
*
(Not for publication.)
3.
Date of Birth:
*
(Not for publication.)
mm/dd/yyyy
4.
Years of Residency in District:
*
5.
Work Phone Number:
(Not for publication.)
6.
E-mail Address:
7.
Would you like your e-mail address published?
*
--Please Select--
Yes
No
8.
Address:
*
Education
9.
High School:
*
(Name & Location)
10.
Graduated?
*
--Please Select--
Yes
No
11.
Graduation Year:
12.
Higher Education
College/University
Degree Obtained
1
2
3
4
5
Professional Experience
13.
Current Position:
*
Title
Employer
Location
Years Employed
Current
14.
Previous Positions
Title
Employer
Location
Years Employed
1
2
3
4
5
Personal Background (Optional)
15.
Marital Status:
16.
Spouse's Name:
17.
Spouse's Employment:
Title
Employer
Location
Years Employed
Current:
18.
Children:
Name
Grade (if relevant)
Current School, College or Employment
High School & Graduation Year (include anticipated)
1
2
3
4
5
19.
Reasons for Interest in Serving on the Board of Education:
*
(Please use complete sentences.)
20.
Community Service:
21.
Board Service
Title of Organization/Committee
Position Held
Years of Service
1
2
3
4
5
TERMS OF ACCEPTANCE and SIGNATURE
I, the applicant, warrant the truthfulness of the information provided in this Board of Education Candidate Datasheet and affirm that the Geneva City School District has my authorization to use the following data in the district newsletter, website, calendar, social media, and for press releases as necessary.
22.
Electronic Signature
*
(Please type your First and Last Name)
23.
Please check the box if you agree.
*
I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.
24.
Date:
*
mm/dd/yyyy
Press "Done" when you have completed this form.
Please e-mail a headshot of yourself to hswanson@genevacsd.org
Please ensure that the photo includes only you, is high resolution (if sending from a phone, choose "original size"), and has a neutral background. If you prefer, you may contact hswanson@genevacsd.org to arrange a day/time to have your photo taken.