Board of Director Member Application Form

This is an application to run for the Friendly City Food Co-op Board of Directors. Before completing this application, please read our current strategic plan as well as our equity & justice committee’s “what” & “why” statements.

Our Board governs through a process called Policy Governance. The model emphasizes the board’s role in clearly stating what the organization is to accomplish (Ends Policies) while avoiding unacceptable actions (Executive Limitations Policies). The Board also writes policies about its own governing process as well as policies that describe its relationship to the General Manager.

As you examine our policies, it’s important to understand that the Board’s job is to explain through its policies what it expects of the organization and then delegates all related issues beyond the written policies on Ends and Executive Limitations to our General Manager. So, as long as the General Manager accomplishes our Ends and avoids those situations described in Executive Limitations, the board is satisfied. We as a Board strive to do our job and allow our General Manager to do the work we delegate to her/him. The General Manager demonstrates accountability to the Board by producing regular reports explaining how they are complying with Board policies

Please Note: Your responses to the questions in Section 2 will be made public to Co-op Owners as your candidate profile.

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Name*
Address*
Please respond to ONE of the prompts below (your choice) and ensure you have read the what & why statements linked above.
Please type your initials beside each statement below as your act of confirmation:
Per ABC regulations, because no shareholder owns more than 10 percent of the corporation, all officers and directors are required to complete the following.
Do you currently have financial interest in any business selling alcoholic beverages?*
Have you ever had any type of alcoholic beverage license refused, revoked or suspended?*
Have you ever been convicted of any of the following:
Motor vehicle violation(s) (not including parking tickets)?*
Driving while intoxicated?*
Other criminal offense(s)?*
Are you an elected or appointed official of the Commonwealth of Virginia or any political subdivision thereof?*

Failure to disclose ownership interest in your business or falsification and/or misrepresentation of information may result in refusal of your license and/or criminal charges, which may include the Class 5 felony of perjury

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