Mississippi Administrative Code › Title 10 - Education Institutions and Agencies › Part 402 - MCSAB Board Policies › Chapter 2 - Application Toolkit 2013 › Rule 10-402-2.8 - Charter School Board Member Questionnaire

Current through June 25, 2024
Charter School Board Member Questionnaire
(To be completed individually by each proposed board member
				  for the Charter School)
The purposes of this survey are: 1) to supply pertinent
				  information to the application review team; 2) to encourage board members to
				  reflect individually as well as collectively on their common mission, purposes,
				  and obligations at the earliest stage of school development; and 3) to identify
				  any potential conflict of interest you may have as a board member.
Conflict of Interest
The information requested below is being requested to
				  identify any potential conflicts of interest that you may have as a board
				  member. This is in alignment with best practices in non-profit and charter
				  school governance and is also DPS policy for its board members. If the charter
				  school is approved, any conflict of interest that is identified must be
				  addressed by the charter school in alignment with its board conflict of
				  interest policy.
Background/Criminal History Checks
Background checks are an important volunteer management tool
				  for charter schools. The safety of students, employees, and board members is of
				  upmost importance. Moreover, the judicious oversight of the school's finances
				  and operations is among the governing board's main responsibilities.
				  Accordingly, applicant is to submit criminal background checks on all Charter
				  School Board Members.
Contact Information
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Please check each area of expertise you would
				  contribute to the board:
Community Service
Education
Finance Fundraising
Law
Management
Marketing
Parental Personnel Involvement
Public Relations
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If yes, please describe.
School Mission and Program:
1. What is your understanding of the school's
				mission and guiding beliefs?
2.
				What is your understanding of the school's proposed educational
				program?
3. What do you believe to
				be the characteristics of a successful school?
Governance:
1. Why do you wish to serve on the
				board?
2. What is your
				understanding of the appropriate role of a public charter school board
				member?
3. Describe any previous
				experience you have that is relevant to serving on the charter school's board
				(e.g., other board service). If you have not had previous experience of this
				nature, explain why you have the capability to be an effective board
				member.
4. Provide a forecast of
				where you see the school after its first year of operation and then again in
				four years. Please be sure to include high level
				academic
and
financial components.
5. What specific steps do you think the
				charter school board will need to take to ensure that the school is
				successful?
6. How would you handle
				a situation in which you believe one or more members of the school's board was
				acting unethically or not in the best interests of the school?
Certification
I recognize that all information submitted with this conflict
				  of interest disclosure (with the exception of the background check) becomes a
				  matter of public record, subject by law to disclosure upon request to members
				  of the general public. I will hold the Mississippi Charter School Authorizer
				  Board, its trustees, officers, employees or authorized agents harmless from
				  liability for the disclosure of any information it reasonably believes is true
				  based upon my representations.
I hereby certify that the information contained in this
				  document is true and complete to the best of my knowledge and, if the proposed
				  charter school is approved, agree to notify the chair of the board at the
				  charter school at which I will serve of any change that may create a conflict
				  of interest. Further, if the proposed charter school is approved, I recognize
				  that falsification or failure to submit a complete annual conflict of
				  disclosure becomes justification for removal.
______________________________________________________________________
Board Member's Signature
Date
______________________________________________________________________
Board Member's Typed Name
Date
Miss. Code Ann. §
										37-28-15