Open Board Membership

Thank you for your interest to serve as a Board member of the Quality Smile Restorers Inc. Although this is a non-paid professional position and responsibility, serving on the board remains a rewarding experience and an opportunity for personal and professional growth. You will play a critical and vital role in contributing to the personal and communal development in the society. Completing this form will help you reflect to, and understand your role and commitment of this leadership position. It is important that you read through the entire application before you complete the form.

Applications are used by the Board’s Nominating Committee to identify and evaluate potential board candidates. All new directors are elected by a majority vote of current board members.

Download Open Board Membership Application From Here

Personal Information

Name (as it is in your official ID)

ID Card #/Nationality

Current Job Position /Title

Number of years with current company

Company you affiliate/associate with

Personal Address City/State/Zip Code

Personal Phone Number

Emergency Contact Info Full Name/Relationship type/ Phone Number/Email

Are you willing to go through a Background Check if selected as Board Member?

Yes

Provide Two References Full Name/ Phone Number Full Name/Phone Number

Educational and Professional Background

School/University

Program

Degree Earned

Year

Other Achievements (if any. Otherwise please write N/A)

Community Engagement Activity (if any. Otherwise please write N/A)

Work History (please write: Name of company/ position / starting year and ending year)

Board Candidate Questionnaire

1. If selected, how do you feel you could contribute to the success of the Quality Smile Restorers International?

2. Are you willing to give time, energy and resources to support the mission of the Quality Smile Restorers International? In what way do you think you can serve a nonprofit organization of this nature?

3. Members stay connected to the Smile Restorers at National and International level through meeting attendance, committee work, membership events, e-mail and other QSR communications. Do you have the time and resources to be an active Member of the QSR National Board? __________ If yes, how much time are you willing to commit to the organization in week?

4. Are you comfortable soliciting others for membership and funding? ______ If yes, describe any prior experience(s) in soliciting.

5. What does leadership mean to you?

6. What do you believe are the two most significant issues or problems facing the community and how do you think QSR can help to address these issues?

7. Why do you want to serve as a Board Member of QSR International Organization?

8. Are you open to have an interview with the Executive Committee? ________ If yes, what is your availability? Please tell us the best time(s) and date(s), to call you for a face-to-face interview

Meet Current Board Members and Advising Committee Members

Open Board Membership

Open Board Membership

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