Alumni Association Board of Directors Nomination Form

Please complete this form to provide your information to the Nominating Committee to be considered for a director position.



Name:

Graduation Year:

Contact Information

Address:

City: State: Zip Code:

Phone:

Email Address:

Employment Information

Employer: Job Title:

Type of Industry:

Family

Spouse:

Children (names and ages):

Have any other family members or relatives attended Shippensburg? Please include name, relationship, and graduation year.

Education

Shippensburg major and Graduation Year:

Advanced Degrees Earned (include degree and institution):

Professional Information

Professional awards or achievements - indicate award and year:

Community Service (past and present)

Service to Shippensburg University (past and present)

What qualifications would you bring to the SUAA Board of Directors?

Goal Statement

Please provide a statement(s) reflecting your reason or interests in becoming a member of the Alumni Board.


Please list references and contact information (one reference should be affiliated with Shippensburg University if possible).

I have completed the requested information for consideration by the Nominating Committee and I have read and agree to serve, if selected, in accordance with the “Position Description” for members of the Alumni Board of Directors.

Signature (or type if sending electronically): Date: