Board Member Application

Board Membership Application

Dear Prospective Board Member: DayStar Ranch, Inc. (DSRI) supports host ranches in Northern California with the mission of empowering individuals with the knowledge and skills needed to live healthful lives with the use of horse activities and other horse associated services. Our vision is that all the DSRI’s host ranches throughout Northern California will contribute to the unity and harmony within the community in which they service through the promotion of horse associated programs which focuses on healing, empowering, and strengthening the individual as well as their relationships with family, friends, and the community-at-large. We thank you for your interest in becoming a trusted board member for DSRI. Enclosed is an application for you to complete and return prior to our Annual Board Meeting, which will be held on November 14, 2009. If you would like more information about DSRI, please visit our website daystarranch.org or call us at 530.529.2679.

DayStar Ranch ● P.O. Box 224 ● Red Bluff CA 96080 ● (530) 5292679.

BOARD MEMBER APPLICATION Name________________________________________________________ Date __________________________ Address_____________________________________________________________________________________ City_______________________________________ State___________________ Zip______________________ Home Phone_________________________ Work Phone_____________________ Cell Phone_______________ Emergency Contact Name __________________________________________ Phone______________________ SKILLS AND INTEREST (APPLICABLE TO THE BOARD POSITION)

……………………………………………………………………………………………………………….. □ management □ public relations □ marketing □ fundraising □ special events □ community relations □ education □ training □ public speaking □ lobbying Current occupation____________________________________________________________________________ Hobbies, skills, interests ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ Previous board or committee experiences ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ Please answer the following questions: 

Will you attend regular meetings and special meetings?

□ yes

□ no



Will you attend a new member orientation?

□ yes

□ no



Would you consider a quarterly financial commitment of $ 25.00?

□ yes

□ no

AVAILABILITY

……………………………………………………………………………………………………………….. At what times are you available? Mondays AM/PM

Tuesdays AM/PM

Wednesdays AM/PM

Thursdays AM/PM

Fridays AM/PM

Saturdays AM/PM

DayStar Ranch ● P.O. Box 224 ● Red Bluff CA 96080 ● (530) 529-2679.

Sundays AM/PM

BACKGROUND VERIFICATION

……………………………………………………………………………………………………………….. Have you ever been convicted of a criminal offense? □ yes □ no Have you ever been charged of neglect, abuse, or assault? □ yes □ no Has your driver license ever been suspended or revoked in any state? □ yes □ no Do you use illegal drugs? □ yes □ no Do you have any physical limitations or are you under any course of treatment which might limit your ability to perform certain types of work? □ yes □ no

List three names (along with their contact information) of individuals who can provide character references. Include at least one professional reference. Name __________________________ __________________________ __________________________

Contact Number ______________________ ______________________ ______________________

Relevance __________________________ __________________________ __________________________

PERMISSION TO PERFORM BACKGROUND & REFERENCE CHECK

……………………………………………………………………………………………………………….. I hereby allow Daystar Ranch to perform a check of my background, including

 Criminal record  Driving record  Past employee/volunteer history  Personal references  Physician or Therapist I understand that I do not have to agree to this background check, but that refusal to do so may exclude me from consideration for some types of volunteer/board work. I understand that information collected during this background check will be appropriately limited to determining my suitability for particular types of volunteer/board work and that all such information collected during the check will be kept confidential. I herby also extend my permission to those individuals or organizations contracted for the purpose of this background check to give their full and honest evaluations of my suitability of the described volunteer/board work and such other information as they deem appropriate Sign_______________________________________________ Date____________________________________ ……………………………………………………………………………………………………………….. How did you hear about us?  Position description  Advertisement  Volunteer Center/Website Posting  Website

 Family/Friend/Co-workers  Client of Agency  Employee of Agency  Other

SIGNATURE DayStar Ranch ● P.O. Box 224 ● Red Bluff CA 96080 ● (530) 529-2679.

Print Name ______________________________________ Signature___________________________________________

DayStar Ranch ● P.O. Box 224 ● Red Bluff CA 96080 ● (530) 529-2679.

DAYSTAR RANCH CONFIDENTIALITY STATEMENT

Date_______________________ I, ________________________, agree to keep any information learned, seen or heard associated with DayStar Ranch kept confidential. I understand that it is a violation to disclose any information associated with DayStar Ranch, Inc. My signature indicates my understanding and agreement of the above statements and will comply accordingly.

Print Name Signature Date

_________________________________ _________________________________ _________________________________

ADMINISTRATIVE AND FUNCTIONAL STRUCTURE OF DAYSTAR RANCH, INC. Board

Although the Board of DSRI holds fiduciary responsibilities of the organization, its primary purpose is to provide counsel that effectuates the overall management of the organization in the pursuit of achieving DSRI long term goals. It is the Board’s responsibility to uphold the by-laws of the organization and to provide consultative support to the establishment and maintenance of the organization’s policies and procedures.

Committees

Made up of volunteers, DSRI’s committees assist the Board of DSRI in discharging its oversight responsibilities by fulfilling its duties as assigned.

Executive Director

The Executive Director manages the day to day function of DSRI while providing the Board of DSRI a report on the progress of the organization in its endeavors to achieve it long term goal.

Host Ranches

Member Host Ranches, while following DSRI’s polices and procedures offers approved equine related services to the local community and advisory services to the Board of DSRI.

Consultants

When necessary, the Board of DSRI will request the services of consultants to assist the organization and its host ranches in the areas of: Ranch Management, Program Management (Learning and Therapeutic Programs), Community Economic Development, and Business Development) as a part of a committee action.

FOUR KEY FUNCTIONS OF THE DAYSTAR RANCH, INC. BOARD DSRI’s board members are expected to meet four times a year, with the expectation that board members who are constituents of committees are expected to meet as needed. Below, is a breakdown of time as a contributing board member: 1. 2. 3.

4.

Financial Resource Development (50% of time and focus) Strategic Leadership within the Community (25% of time and focus) Governance of Host Ranch Membership (10% of time and focus) Consultation to Executive Director (15% of time and focus)

ADDITIONAL INFORMATION REQUESTED

Please provide a copy of your resume and a biography that answer the following questions: Your experience as a member of other community groups Your definition of Equine Assisted Learning and Psychotherapy Your life experience(s) have you had which would add to your being a member Your reason why you want to serve on the DayStar Ranch Board Your special interests or areas of expertise that you can offer to DayStar Ranch, Inc. ……………………………………………………………………………………………………………………....... SUBMITTING YOUR APPLICATION

Return the requested documents to DayStar Ranch, Inc. prior to Nov 1, 2009. DayStar Ranch PO Box 224 Red Bluff, CA 96080 For more information call 530.529.2679 or email [email protected]

Thank you for your interest! Sincerely, DayStar Ranch, Inc.