Nominate a Board Member

Title:

First Name:*

Middle Name:

Last Name:*

Suffix:

Class Year:

Address Line 1:*

Address Line 2:

City:*

States:*

Zip:*

Home Phone:*

Preferred Email Address:

Email:*

After reviewing the mission statement and vision of the association, what contributions do you think you can make as a member of the board?

Contributions:*

What is your professional experience and why do you feel it is applicable to being a board member?

Professional Experience:*

Have you ever volunteered service to ESU? If so, in what capacity? If not, how much time do you think you can volunteer on an annual basis? Would there be any reason why you could not attend the regular board or committee meetings?

Volunteer:*

Please list all current and past volunteer activities. Please indicate what your role was and how much time was committed.

Past Volunteer Activities:*

Where you ever part of any groups/organizations at ESU? If so, please indicate which ones and what capacity you served.

Groups/organizations at ESU:*

Do you have any Professional Awards and Achievements? If so, please indicate what you received.

Professional Awards and Achievements:*

Do you have family members or relatives who attend/attended ESU?*

Why did you choose to go to ESU and why is it important to you now?

Why ESU:*

If not included on your resume, what was/were your degree(s) from ESU in and which year did you graduate? In which year (s) did you attain an additional degree(s) at ESU?

Additional degree(s) at ESU:*

Personal Background Information

Have you ever been arrested, indicted, or convicted of any criminal offense in the last 10 years?*

If yes, please explain in full:

Please provide 2-3 references that we may call on your behalf.

1st Reference: *

2nd Reference:*

3rd Reference: