Board Member Application

Board of Directors and Advisory Board
2019 Application Form

Thank you for your interest in serving on the Autism Society Acadiana Board of Directors or the Advisory Board!

Please carefully read the information on Autism Society Acadiana Board and Advisory Board duties and responsibilities located in Appendices 1, 2, & 3.
Please complete pages 1 & 2, with questions on page 3 answered on a separate sheet of paper. Your application may be typed or handwritten. Your completed application can be returned to Autism Society Acadiana by email: [email protected] or by postal mail: 3108 W. Pinhook Road, Ste. 101, Lafayette, La. 70508 or fax: 337-235-4427.
To be considered, we must have your application no later than April 24, 2019. Applicants may be interviewed by the current Board of Directors. Interviews will take place Saturday, April 27.

Please check one option below:

I am submitting my application to be considered to be placed on the ballot for a seat on the Autism Society Acadiana Board of Directors.
I am submitting an application in order to be considered for a seat on the Autism Society Acadiana Advisory Board.
Day #Evening #

I. Employment Experience: List in chronological order beginning with your current or most recent position. Please provide resume and/or curriculum vitae if available and applicable. Please spell out complete names. Please do not use abbreviations or acronyms.

Position/Title – Organization Name – From/To

Yes No

II. Volunteer Experience: Please list your most recent volunteer experiences, including those with organizations other than Autism Society Acadiana. Please use the complete name of the organization rather than an abbreviation or an acronym.

Position/Title – Organization Name – From/To


III. Educational Background: Please list your highest level of education beginning with most recent.

Institution – Degree/Field – Year


IV. Significant Honors, Awards, Special Recognitions: Please use complete names rather than abbreviations or acronyms

Organizations – Year – Honor/Award. Please spell out complete name. No abbreviations or acronyms.


V. Applicant Self-Evaluation: Please answer the following questions to show how your training and experiences would benefit Autism Society Acadiana as a member of our Board of Directors or our Advisory Board. Please use a 12 pt. font and no more than one page per question. You must complete this section for your application to be considered valid and complete.


1. Are you a member of the Autism Society? Are you familiar with autism? If so, how did you gain your knowledge about autism?

2. How would Autism Society Acadiana Board of Directors benefit from your participation as a board member? Please include information about your: a) governance skills, b)fundraising experience, c) teamwork skills, d)leadership skills, and e) experience in reaching out to diverse populations. What other non-profit boards have you served on?

3. The Autism Society Acadiana Board of Directors is an active working board. Please review the board positions (if available) and identify your interest and qualifications for these position(s).

  • President: focuses on fundraising, budgeting, governance, board meetings, presides over board meetings

  • Vice President: focuses on business matters of organization. Will step in to position of president should the need arise.

  • Treasurer: focuses on initiating and overseeing budget process, oversees expenditures with assistance of bookkeeper, administers stipend program (administrative assistant), files financial statement (non-profit tax return)

  • Secretary: focuses on keeping board meeting minutes, collecting agendas from all chapter committees and support group meetings (administrative assistant), keeps membership records (administrative assistant), state corporation filings (administrative assistant)

  • Other critical board needs:
    • Chairperson Walk for Hope
    • Chairperson Trivia Night
    • Chairperson Mini-grants Committee
    • Chairperson Governance & Board Development
    • Public Relations Chair/Specialist
    • Provide assistance with maintaining website

Appendix 1
Acadiana Affiliate, Autism Society Organization

The Acadiana Chapter is a regional chapter affiliate of the national Autism Society serving over 780 family households and members in the parishes of Lafayette, Acadiana, Evangeline, St. Landry, Iberia, St. Martin, and Vermilion. The organization was founded in 1985 by a small group of parents and professionals intent on providing support, education, and resources to local families raising children with autism. Our greatest challenge is to continue to serve individual families as the autism community and our chapter continues to expand. Our commitment to the autism community focuses on 1) support, 2) awareness, 3) information, 4)education, and 5) recreation.

Mission: Improving the lives of all affected by autism.

Options Policy: We believe each family and individual with autism should have the right to learn about and then select, the options that they feel are most appropriate for the individual with autism. To the maximum extent possible, we believe that the decisions should be made by both the parents and the individual with autism.

Fundraising: We have at least 2 major fundraisers: the Walk for Hope and Trivia Night, which the community generously supports us during these fundraisers and other fundraisers throughout the year.

Services: We provide or support a variety of programs and services to our membership:

  • Community Information and Support Meetings – we host meetings providing educational literature, administrative and office support to the groups meeting in the various parishes facilitated by individuals from those communities. Our area parish support meetings include:
    • Lafayette
    • Acadia
    • Iberia/St. Martin
    • Managing Aspergers Together (MAT)
    • Just 4 Moms
    • STARS (Siblings Talking About Real Stuff)
    • St. Landry – Currently Inactive
    • Vermilion – Currently Inactive
    • Evangeline - Currently Inactive
    • Adult Issues in Autism – Currently Inactive
    • Kids Club – Currently Inactive

  • Mini-grant Program -- Provides funding to educators for creative and innovative tools and programs tailored to support students with autism.

  • Recreational Stipends -- Available to families of a child or adult with autism to help defray the cost of recreation or leisure activities chosen by family of the individual with autism. This is one of the first programs developed by Autism Society Acadiana. Applicants must be members of Autism Society Acadiana.

  • Educational Stipends – Available to families wishing to attend a conference or workshop. Can also be used to help families obtain an electronic device or an assistive technology communication device to help their child learn and communicate. Applicants are reimbursed for the cost of the device or the conference or workshop. Proper documentation is required.

  • Project Keep Our Kids Safe – Available to members with children with autism that are prone to wander or elope. The program provides an AngelSense GPS tracking device and three months of monitoring service. The recipient is responsible for maintaining the service after the initial three months.

  • Kid Friendly Kuts – LaFamille Hair Salon in Lafayette opens one day a month outside its normal business hours to help children with autism learn to tolerate a haircut in a salon. To participate, families must reserve their spot by contacting Autism Society Acadiana. Participants are responsible for the cost of haircut.

  • Annual Meeting of Membership & Fun Day – A picnic for our members with activities geared for our younger members. Other local organizations and agencies that serve the autism community are invited to host a booth to provide information on their services. An update on our programs and services is also provided.

  • Recreational Events – Events held throughout the year include our annual Back-to-School Swim Party, our holiday party, bowling, baseball games and other athletic events.

  • Workshops, Conferences, Seminars on Autism or Autism-Related Topics - A variety of educational and informational presentations are offered throughout the year for our members and general public.

  • Lending Library – Provides books, DVDs, and magazines on various autism-related issues. Housed at our office in Lafayette, members may check out items for up to 30 days.

Appendix 2
Members of the Board of Directors of the Autism Society Acadiana serve an important role within the organization. The future of the Autism Society Acadiana is in large part ensured through the active participation of its board. Service as a board member holds certain expectations in terms of involvement, participation, support and commitment to the Autism Society’s mission. Prospective and incumbent board members should commit themselves to the following:
  • Understand and support Autism Society Acadiana’s mission, vision, and values

  • Exercise the core duties of care and loyalty in a manner consistent with the best interests of the mission of the organization.

  • Be knowledgeable and current on the various services Autism Society Acadiana offers, follow trends in the social services, policy and legislative arenas that affect Autism Society Acadiana and children and adults with autism spectrum disorders and other neurological development disabilities or special needs; be familiar with the history and current organizational structure of Autism Society Acadiana.

  • As a Board member, your principle responsibilities will entail fiduciary, strategic and governance activities. The expectations are that these practices will model that of the best standards of corporate and nonprofit governance.

  • Support the decisions of the board. Once a decision has been made, it is the decision of the board. Board members are expected to engage in the informed and respectful exchange of possible differing thoughts and perspectives leading up to a vote in a matter coming before the board. Once the board has voted on a matter, the director’s duty of loyalty precludes the individual directors from expressing public criticism of the decision.

  • Make known and make available your talents, skills and areas of expertise; serve in leadership positions and undertake special assignments. Use any special skills or training you may have to further the work of the board and of Autism Society Acadiana. Express professional disagreement in a way that moves the discussion forward.

  • Exercise oversight with respect to Autism Society Acadiana’s compliance with all applicable laws and regulations.

  • Develop a rapport and be respectful and encouraging with fellow board members; be accessible to other board members via phone and email before meetings as needed.

  • Regularly assess board performance; suggest possible nominees to the board who clearly are individuals of achievement and distinction and who can contribute to the work of the board and the organization’s process.

  • Enhance the Autism Society Acadiana’s public standing; serve as an Autism Society Acadiana advocate and ambassador to family, friends, business associates, and other constituents; convey the significant impact the organization has in the lives of children and adults with autism spectrum disorders, and other similar special needs and their families.

  • Establish as a high priority attendance and participation in all regular board meetings, conference calls.

  • Serve as asked as an active member on committees; attend all of its regular meetings (and, in some cases, conference calls); participate fully in its work.

  • Suggest agenda items periodically for board and committee meetings to ensure that significant, policy-related matters are addressed. Arrive prepared to discuss the issues and business to be addressed at board and committee meetings, having reviewed the materials in advance.

  • Maintain confidentiality of board and committee executive sessions, and speak for the board or organization only when authorized to do so.

Financial Matters:
  • Exercise overall fiduciary responsibility to ensure organizational fiscal stability and accountability and to maintain legal and ethical integrity.

Philanthropic Support:
  • Each Board Member will be expected to support all aspects of the strategic and business plan and will contribute through fundraising and executive leadership activities to assist in achieving intended outcomes.

  • Assist in fundraising for the organization through personal influence with contacts, including individuals, corporations, and foundations.

Avoiding Conflict:
  • Serve Autism Society Acadiana as a whole rather than any special interest group; maintain independence and objectivity as a sense of fairness, ethics and personal integrity dictate.

  • Use good faith efforts to avoid interests that could create a potential conflict of interest; avoid even the appearance of a conflict of interest that might create a conflict for the board or the organization; and if such a conflict does arise, declare that conflict before the board in a timely fashion and refrain from voting on matters affected by the conflict. Never accept (or offer) favors or gifts from (or to) anyone who does business with Autism Society Acadiana.

Appendix 3
Advisory Board

The Affiliate may establish an Advisory Board as deemed appropriate to further the mission of The Autism Society Acadiana and purposes of the Affiliate. Advisory Board Members shall be a vehicle to gain advice and assistance from persons with a specific knowledge or skill set to foster the support for the programs and services of the Affiliate. The functions and organizational structure of each Advisory Board Member shall be determined when an advisory member is established and shall not be inconsistent with the functions of the Board of Directors as set forth in these bylaws. Advisory Board Members may attend meetings and discussions with the Board of Directors but may not have voting privileges during voting procedures.

SECTION 1. Election and Term of Office. The Advisory Board members of the Affiliate must be current members of the Affiliate. Each Advisory Board member shall hold office until the next annual meeting of the Board of Directors. Each year, Board of Directors will evaluate each Advisory Board member and decide whether to invite the member back for an additional term. No maximum term is specified as set forth in these bylaws. Each member may serve as long as invited by the Board of Directors. Advisory Board member may resign from the position at any time.