Nomination Form For ESU Alumni Board

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ESU Alumni Board

Board Nominee Information

First Name*

Middle Name

Last Name*

Name at ESU graduation if different from above

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone

eMail Address

Current or Last Employer

Title

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

Education Information

ESU Degree/Major:

Graduation Year

Other Degrees (include institution and degrees if applicable)

Groups / Activities while attending ESU

Describe any involvement that you have had with ESU and its associated organizations (Alumni Association, fraternities, sororities, etc.) since graduation.

Person #1

Please include three references. Select individuals who know you well and can speak about your skills and abilities, as well as your ability to work in a team environment. Include their name, phone number where they can most likely be reached, and identify your association with them (current or former employer, former ESU professor, etc.)

Full Name

Phone Number

Association with reference

Person #2

Full Name

Phone Number

Association with reference

Person #3

Full Name

Phone Number

Association with reference

What do you hope to achieve by joining the Board of Directors of the Alumni Association?