Board of Directors Application

1. Nomination by Committee

The deadline to submit your completed application to Golden Valley Electric Association is:

5 p.m. on Wednesday, January 17, 2024 – The documents that must be submitted include:
- Completed and Signed Application (see more information below)
- Criminal Records Check Report (obtained via the State Troopers office on Peger Road)

Note: GVEA will publish your candidate information verbatim when advertising this election. Staff will make no corrections for grammar, spelling, etc. Please make sure your submitted information has been proofread and is in the format you wish it to appear.

Next Steps

The Board Secretary, or his/her designee in the event the Secretary is a candidate, and a designated GVEA staff person will review and vet applications to ensure they contain all required documentation and meet required qualifications.
All applicants who are forwarded to the nominating committee will be interviewed by their district’s Nominating Committee.

Note: Applicants whose applications are deemed incomplete will be contacted by GVEA staff, using the contact information provided, to offer the opportunity for the candidate to submit or resubmit missing or incomplete documents within three business days from notification.

Personal Information

Name(Required)

First Last

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Location of Your Primary Residence(Required)

Primary Phone(Required)

Secondary Phone

Email(Required)

Social Media Sites You Maintain

Click the + to add another entry

Note: If the nominating committee selects you as a candidate, GVEA will only make public the contact information that you specifically authorize, which we will confirm with you. All other contact information will be used exclusively by GVEA and the nominating committee for the purpose of communicating with you.

GVEA Voting District(Required)

How long have you lived in this district?(Required)

GVEA Account Number(Required)

Total length of time as a GVEA member (Number of years)(Required)

How long have you lived in Alaska?(Required)

Members in your immediate family(Required)

Summarize your personal interests/hobbies (50 word limit)(Required)

Professional Information

Employer(Required)

Occupation(Required)

(If retired, former occupation)

Education(Required)

(College degrees, certificates, etc.)

Please list any GVEA employees or board members you are related to, or share accommodations with

Click the + button to add a new row

Name

Relationship

Are you an officer for a collective bargaining unit with which GVEA has a labor contract?(Required)

Yes

List organizations to which you currently belong. List responsibilities, office held, and dates of service (50 word limit)(Required)

Summarize areas of special interest to you and/or your community service (100 word limit)(Required)

Why are you interested in running for a seat on GVEA's board? (150 word limit)(Required)

Conflict of Interest Certification & Disclosure Statement

The undersigned candidate and/or Board member for the Board of Directors (“Board”) of Golden Valley Electric Association.:

Affirms that the Candidate/Board member has received, read and understands the most current version of GVEA’s Conflict of Interest Policy (Section 13, Appendix A, page 34).
Agrees to comply with the Conflict of Interest Policy 2.1.1.
Based upon a good-faith belief, to the best of the Candidate/Board Member’s knowledge, and except fo the material facts disclosed below, certifies that the Candidate/Board Member currently complies with the Conflict of Interest Policy.
Discloses the following material facts known to the Candidate/Board Member regarding any actual or potential employment, income, competition, Conflict of Interest activity referenced in the Conflict of Interest Policy that could impact the Candidate/Board Member’s compliance with the Policy.
Agrees to immediately disclose to the Board any material facts that become known to the Candidate/Board Member regarding any actual or potential employment, income, competition, Conflict of Interest activity referenced in the Conflict of Interest Policy that could impact the Candidate/Board Member’s compliance with the Conflict of Interest Policy.

Do you have any material facts known to the Candidate/Board Member regarding any actual or potential employment, income, competition, Conflict of Interest activity referenced in the Conflict of Interest Policy?(Required)

Yes

Disclose any actual or potential conflict of interest(Required)

Background Check Report(Required)

The candidate is responsible for obtaining their background check report directly from the Alaska State Troopers. The cost is $20/per report and generally can be obtained while waiting at the Alaska State Troopers office on Peger Road in Fairbanks or Deborah Street in Delta Junction, Alaska. The report must be uploaded with your application and needs to be dated no earlier than 90 days prior to the application deadline.

Max. file size: 300 MB.

Petition Signature Form(Required)

Prior to beginning the petition process, the petitioner must contact GVEA staff to verify petitioner has a GVEA membership in their name for the district in which they are petitioning. Staff will then provide a Petition Signature Form, which has been approved by the Association’s Attorney. Petitioner should plan to collect at least 25% more than the minimum bylaw requirement. Signatures collected may be invalid for several reasons including: Signer not on the account; Wrong district; Both members of a joint account signed – joint accounts qualify as one membership and only one signature will be valid. Contact GVEA staff for these forms.

Max. file size: 300 MB.

Candidate Declaration

Candidate's Electronic Signature (Full Name)(Required)

Phone

This field is for validation purposes and should be left unchanged.