Board of Directors Application

If you are elected to the Board, by completing this application you agree that you can commit the time needed to serve (estimated at 2 – 4 hours per month), and that you do not have any known conflicts of interest in participating on the board.

Name *

First

Last

Email *

Phone *

How long have you been a member of the CCA? *

Colorado Chiropractic License Number

Executive Committee Positions: If running for a position on the Executive Committee, please select the position you are applying for. Members wishing to serve on the Executive Committee Be a CCA member for a minimum of two years prior to competing for the Executive Committee position.

Secretary
Vice-President

District Director Positions: District Directors must live or work in the district, with the exception of Director-at-Large (must live or work anywhere in the State). Please list which district you are applying for. A district map and zip code listing can be found at https://coloradochiropractic.org/wp-content/uploads/2023/05/CCA-Dist-by-Zip.pdf

District 2
District 5/6
District 8
District 9
Director-at-Large

What is your understanding of the CCA's mission, vision, and values? *

Explain how your skills and experiences align with the CCA's goals and how you think you will contribute *

What do you know about our organization’s history and current challenges? *

What is your vision for the future of our organization? *

Do you have any experience with non-profit governance and oversight? *

Which of your skills would the board and the organization appreciate most about you? Check all those that apply: *

Board Development
Strategic Planning
Program Development
Membership Development
Financial Management
Fundraising
Communications
Marketing
Legislative Advocacy
Community Collaborations
Health Insurance Knowledge (billing, coding, contracts, etc)
Event Planning

Any additional skills that you would like to highlight?

How do you stay informed about industry trends and challenges? *

How would you leverage your network to benefit our organization? *

Describe your experience with financial management and oversight. *

Colorado Chiropractic Association

**New Address – By Appointment Only**

9200 East Mineral Avenue, Suite 100
Centennial, CO 80231

Phone: 303.755.9011
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