Home About Leadership Opportunities Board and Nominating Committee Application Board and Nominating Committee Application Step 1 of 7 14% Please indicate which position you are applying for:*National Pork BoardNational Pork Board Nominating CommitteeThis form must be completed and submitted by November 1st. Interviews will be held at the beginning of December in Des Moines; please pencil early December onto your calendar. A photograph of each candidate will be taken while in Des Moines for Forum materials as part of the interview process. We will be sending you more information regarding your interview dates and times.EligibilityAre you a person who producers porcine animals in the U.S. for sale in commerce?*YesNoAre you an authorized representative of a legal entity that qualifies as a producer or an importer that is subject to the checkoff assessment?*YesNoIf you are an authorized representative of a pork producing or importing entity, in what state is this entity headquartered?* AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Are you, or the legal entity you represent, fully paid up on all checkoff assessments due?*YesNoIt is the purpose of the Pork Promotion, Research, and Consumer Information Act to establish an orderly procedure for financing, through adequate assessments, and carrying out an effective and coordinated program of promotion, research, and consumer information designed to strengthen the position of the pork industry in the marketplace; and maintain, develop, and expand markets for pork and pork products. Is there anything that would prevent you from positively contributing to and impacting this purpose?*YesNoIf yes, please explain* I. Personal InformationName as it appears on your driver's license* First Middle Last Suffix Date of Birth* Date Format: MM slash DD slash YYYY Residence Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Office PhoneMobile PhoneFaxEmail Address* Highest level of education completed*High SchoolCollegeDegree level*Trade SchoolAssociate DegreeBachelor's DegreeMaster's DegreeDoctorate DegreeIf college, name of school*Are you now, or have you ever been a Federal Registered Lobbyist?*YesNoThe below information is voluntary and data will not be used to grant preferential treatmentGenderMaleFemaleEthnicity Hispanic or Latino African American American Indian Asian Caucasian Native Hawaiian or Other Pacific Islander Other Please describe: II. Type of Hog OperationName of OperationOperation Type* Farrow to Finish Feeder Pig to Finish Wean to finish Seedstock Producer Farrow to Wean Farrow to Feeder Pig check appropriate linesNumber of SowsNumber Marketed AnnuallyOther LivestockCropsAcreageWhat type of marketing plan do you utilize?What is your involvement in the daily operation of your pig enterprise?owner, manager, operator, contract grower, employee, etc. - please elaborate III. Industry Involvement and year(s) of InvolvementList local pork association service and dates servedList state pork association service and dates servedList national pork association service and dates servedList other farm organizations or commodity groups you are affiliated with and any leadership position you have held.List other activities and organizations you are affiliated withWhich of these checkoff programs have you participated in Operation Main Street (OMS) Transport Quality Assurance (TQA) OMS Neighbor to Neighbor OMS 2.0 Environmental Stewards Transport Quality Assurance (TQA) Pork Promotion Activities Pork Leadership Academy/Institute Other check ALL that applyAre you currently PQA Plus certified?*YesNoIf not, what are your plans to complete your certification before you take office?*Are your facilities currently PQA Plus Site Assessed?*YesNoIf not, what are your plans to complete the site assessment process before you take office?* IV. Industry Outlook/Leadership QualitiesIndustry Knowledge – Big Picture What do you consider the major issue facing the pork industry today?*As you look at the US Pork Industry 5 years from now, what should the national, state or local association do to assist members to be part of that pork production future?*Pork Board, Checkoff Knowledge, programs, ideasWhat do you think should be the main goal of the Checkoff and National Pork Board?*How strong a role do you believe the Pork checkoff should play in trying to get 100% of producers PQA Plus Certified and Site Assessed?*How strong a role do you believe the Pork checkoff should play in urging producers to live by the ethical principles in order to enhance consumer trust?*Leadership skills - Active InvolvementWhat are your strengths and weaknesses as a leader?Strengths? Give specific examples.*Weaknesses? Give specific examples*Given the changes taking place in the pork industry (larger operations, fewer producers, gestation crates vs pens, use of antibiotics etc), what role do you believe the Pork checkoff should play in assisting producers to adapt to these changes.*CommunicationsAre you an effective communicator?*Give examples.Are you a good listener?*Give examples.Attitude: Passion and commitment to the pork industryDescribe an experience that demonstrates your willingness to sacrifice time, money and other goals to serve the pork industry*Provide an example of where you had to stand up and defend pork production and/or the U.S. Pork Industry?*Why are you seeking this position?*Have you reviewed the linked documents which outline the time commitment necessary if elected to the position you are seeking?*YesNoIf applying for a position on Pork Board – please read the Pork Board Abstract. If applying for the position of Nominating Committee -- please read the Nominating Committee Abstract.ConclusionAnything you weren’t able to completely convey in the previous questions?* Please Completethis is for staff use in scheduling flights to Des Moines for the interviewName of airport I fly out of*Approximate driving time from home to airport*Will you drive or fly to Des Moines for your interview?*DriveFly Confirmation I am willing to devote my time and personal resources to serve as a member of the leadership position to which I am elected. Applicant Digital Signature:*Please type your full nameDate Date Format: MM slash DD slash YYYY
