Please complete this application by March 15, 2022. Select the Position You are Seeking*President ElectTreasurerSecretaryDirectorAllied DirectorCandidate InformationName First Last TitleAssociation / Company Name*Company Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Years as KCSAE Member*Year First Joined KCSAE*Candidate BackgroundYears of Experience in Association Management*Years in Present Position*Years at Present Employer*List any other Association Management ExperienceList any Professional Designations EarnedDoes Your Current Association/Employer support your KCSAE Involvement? Please Explain.*Please list any awards received related to your career in Association Management and the years received.*Please list any articles published or presentations made related to Association Management.*Please describe your KCSAE involvement.*Are you a member of ASAE, and if so, how long?*Have you been a member of any other ASAE Allied Society (please list name and dates)*Service to KCSAEIn what capacities have you served KCSAE? (Select all that apply)CommitteesTask ForcesBoard of DirectorsOther KCSAEPlease list any other offices held, or service preformed in other professional organizations that you feel is applicable to being a KCSAE Board Member.There is a monthly time commitment involved with being a Board Member. Do you have obligations that will interfere with your ability to be an involved KCSAE Board member?*Why do you wish to become a KCSAE Board member?*What goals do you have for the association and how will you implement them, if elected?*Do you certify that you are a member in good standing with KCSAE and the information provided is accurate to the best of your knowledge?*Please ChoooseYesNoPlease sign this application by typing your name.*Application Date* MM slash DD slash YYYY