HACE Young Professionals Board Application

HACE Young Professionals Board Application
Applicant Information
Full Name:
Date of Birth:
Main Phone:
Current address:
City:
State:
Email:
Ethnicity:
ZIP Code:
Employment Information
Current employer:
Years of professional work
experience:
Job Title:
Phone:
E-mail:
City:
State:
ZIP Code:
Leadership Skills & Information
Promotion or Special Recognition received:
Committees You Lead:
Activities:
Career Goals
Short Term (1 year):
Long Term (3-5 years):
Management
330 S. Wells | Suite 1104 | Chicago IL 60606 | haceonline.org
HACE Young Professionals Board Application
Education
Undergraduate Institution:
Graduate Institution:
Certification:
Other:
Associations & Organizations
Name of Organization:
Role:
Tenure:
Statement of Purpose
Please include a statement, maximum of 500 words, explaining what you hope to achieve and how you
plan to contribute to the HACE Young Professionals Board. Please attach document.
I certify that the information above is true.
Signature of applicant
Date
330 S. Wells | Suite 1104 | Chicago IL 60606 | haceonline.org