The composition of the National Board begins at the state/district level. States that utilize NBCE exams may name delegates and alternates to attend the NBCE annual meeting. At the meeting, district delegates nominate a person to serve as district director. An assembly of all state delegates votes to accept or reject each district nominee. Two seats are filled by appointment by the Federation of Chiropractic Licensing Boards. The board then elects at-large directors for terms ranging from one to three years. Officers are elected annually. The four officers (President, Vice President, Treasurer and Secretary) compose the NBCE Executive Committee.
The NBCE is a private, non-profit organization incorporated in the state of Texas and operates under bylaws.