APPLICATION FOR BOARD NOMINATION FORM (Part

advertisement
APPLICATION FOR BOARD Directors
Must be submitted with petition* no later than December 14, 2009
* The regular process to submit an application to become a candidate to run for the Board of Directors has now closed. A
slate of candidates for the 2010 elections has been approved by the Board and announced to the membership. However, if
you feel you would like to be added to the 2010 slate of candidates the bylaws state that you must submit a petition signed
by no less than 250 Official Representatives who are in good standing, along with this application. You must be listed as
the official member representative and qualified to serve. The application and petition must be received by COMMON
HQ within 14 days of when the announcement of the official slate of candidates is announced to the voting members.
(COMMON Bylaws, Article V, Section 6, Board of Directors)
Are you currently the official member representative for your company or organizational membership?
 Yes  No
COMMON Member User Number:
Name:
Company:
Mailing Address:
Business Telephone:
Contact Phone:
Please review the attached job description for details regarding the specific duties and time commitments expected
of a board member. It is also recommended that you speak with a current board member regarding their position.
This will help you to determine whether you will be able to serve effectively if nominated and elected to the
COMMON Board. If you qualify and are interested in being considered for nomination, please complete the
attached three forms (Part one, two, and three) along with the conflict of interest form.
If you have any questions regarding the nomination procedure, please contact Randy Dufault, the Nominating
Committee Chair, or Ralph Gervasi, Executive Director. Thank you for your interest in serving the COMMON
organization.
Fax the completed application to the attention of:
Ralph Gervasi 312.279.0227
APPLICATION FOR BOARD NOMINATION FORM (Part One)
COMPANY BACKGROUND
Describe your company's business:
Please explain:
 Yes  No
1.
Business Partner
If so, what type _______________________________________
2.
Do you have a financial relationship with IBM
 Yes  No
If so, what type _______________________________________
3.
Do you have a financial relationship with COMMON
 Yes  No
If so, please describe: _______________________________________
4.
Hardware systems installed:
PROFESSIONAL BACKGROUND
Your job title:
Please describe your primary job responsibilities:
What is the title of the person that you report to?
Please describe your experience with personnel management/supervision:
Current:
Past:
Number of years in:
General management positions:
IT Management:
IT
Please describe your educational background: major field of study and degree type (if applicable):
Undergraduate:
Graduate:
Other:
Please list any professional certifications that you hold:
Signature
Date
IT
APPLICATION FOR BOARD NOMINATION FORM (Part Two)
Number of years as a COMMON member:
Number of conferences attended during the last 4 years:
Please list your current COMMON volunteer position(s):
Position
Years
Time Commitment (hours) per Year
Please list your past COMMON volunteer position(s):
Position
Years
Time Commitment (hours) per Year
OTHER ORGANIZATIONS/ASSOCIATIONS
Please list any volunteer organizations in which you are currently an active member, or have been an active volunteer.
Organization
Signature:
Function
Years
Date:
Current Member?
APPLICATION FOR BOARD NOMINATION FORM (Part Three)
Please respond to the following questions: 'if nominated and elected to the board”...
1.
What goals and objectives would you like to see for COMMON? How would you contribute in helping to
achieve these goals?
2.
What key strengths do you think you’d bring to COMMON as a Board member (i.e. Financial, Personal,
Business Planning, etc.)?
3.
Please provide 2 COMMON references and 2 business references?
Signature
Date
Conflict of Interest Form
Name:
Member ID:
Company Name:
Do you, or any individual with whom you directly share income, (a) have a financial interest in any computer hardware vendor or in
any firm furnishing services or goods to COMMON, or (b) receive any personal or professional benefit from the furnishing of services
or goods to COMMON? If yes, also indicate approximately what percentage of your and / or your company’s revenue is realized
from your COMMON relationship.
NO
YES
Please describe:
Are you, or any individual with whom you directly share income been,
(a) Employed by,
(b) Within the last two years, a consultant for,
(c) The holder of an ownership interest (including stock options but excluding indirect investments through mutual funds and the
like) in, or
(d) A recipient of honoraria exceeding $2,000 per year or $5,000 over a three-year period from any computer hardware or
software vendor or an entity having a commercial interest in 1, or which is the proposed or actual subject of, a project, activity or
transaction of COMMON?
NO
YES
Please describe:
Do you serve in a leadership capacity (e.g., board member, committee member, advisor) in other technology-related associations or
societies, or in an entity having a commercial interest in, or which is the proposed or actual subject of, a project, activity or transaction
of COMMON?
NO
YES
Please describe:
Please list any other personal or professional position(s) or interest(s) you currently or are about to hold, or activities in which you are
or are about to be engaged, which reasonably may be anticipated to conflict with the interests of COMMON.
I represent that the information reported above is accurate. I further represent that should a change in circumstances affect my
responses, I will immediately disclose such changes. I understand that, where appropriate, this information may be disclosed
publicly. I further understand that COMMON reserves the right to limit my participation in the relevant activity and/or decisionmaking process if it believes a significant conflict of interest exists. Finally, I understand that failure to complete or update this
Disclosure Form when so requested will automatically disqualify me from participating in the subject project, activity, or
transaction.
Submitted by:
(Signature)
Print Name:
1
Date:
An entity having a commercial interest refers to a company for which the sale or regulation of its products or services may be influenced by COMMON-sponsored
activities, or a direct competitor for COMMON-sponsored products or services.
Board of Directors Job Description
Mission:
The structure and purpose of the Board of Directors is governed by the Bylaws of COMMON. The Board of Directors has sole
fiduciary responsibility for COMMON. The Board of Directors delegates the authority and responsibility for day-to-day activities to
COMMON’s Executive Director. The primary duty of the Board is to concentrate their activities on issues of strategic importance to
the future well being of COMMON.
Reports To:
 The COMMON Membership
Recommended Qualifications:
 Leadership
 Team player
 Experience with budgets and business planning
 Financial management and process management
 Change and quality management
 Participation at the Annual Meeting over the last two (2) years.
 At least five (5) years experience in a system (software, hardware or applications) and/or management environment.
Responsibilities:
 Sets policy and strategic direction for COMMON
 Has fiduciary responsibility for all COMMON Activities
 Provides direction to the Executive Director
 Approves the annual budget
 Maintains communication channels with IBM and all levels of the COMMON organization
 Participation in strategic planning sessions held by User Groups, IBM and/or other organizations that require non-disclosure
 Acts in accordance with COMMON’s Bylaws and Code of Ethics
 Represents COMMON to other user groups
 Votes on issues presented to the Board
Commitment:
 Must be able to commit time required to the term of office set by the election procedures.
 Must be able to attend the Annual Meeting each year, participate in the Saturday Board meeting before the conference, ad
hoc meetings during the week, and the Friday Board Meeting following the end of the Annual Meeting.
 Must be able to attend one Interim Board meetings per year, totaling two days (2) days during the summer (Saturday and
Sunday).
 Must be able to attend one (1) Fall/Winter Strategic Planning meeting per year, totaling three (3) days (Friday, Saturday, and
Sunday.)
 Must be able to attend special meetings called by the President.
 Must be available to participate in conference calls as designated by the President.
Benefits:
 A Director has the opportunity to meet with key personnel in IBM, User Groups and other organizations.
 A Director has the opportunity to interface with key personnel throughout the COMMON organization and to discuss current
technology.
 A Director develops policy and procedures that contribute to making COMMON a dynamic and highly effective
organization, through interaction with COMMON’s membership.
 A Director can experience personal growth through the interchange of ideas with IBM and peer groups, and can expand their
knowledge of planning and managing a large organization.
 A Director has the opportunity to make a significant contribution to COMMON’s future.
Reasons for Dismissal:
 Inability to attend the COMMON Annual Meeting each year.
 Unable to attend Interim Board meetings on a regular basis.
 Failure to attend a Strategic Planning meeting on a yearly basis.
 Unable or unwilling to act in a capacity designated by the Board of Directors.
 Failure to fulfill the responsibilities of the office.
 Failure to act in a way consistent with COMMON’s Code of Ethics and Bylaws.
Download